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Feasibility and effects of nurse run clinics for patients with epilepsy in general practice: randomised controlled trial

Abstract Objective: To test the feasibility and effect of nurse run epilepsy clinics in primary care. Design: A randomised controlled trial of nurse run clinics versus “usual care.” Setting: Six general practices in the South Thames region. Subjects: 251 patients aged over 15 years who were taking anti-epileptic drugs or had a diagnosis of epilepsy and an attack in the past two years who met specified inclusion criteria and had responded to a questionnaire. Main outcome measures: Questionnaire responses and recording of key variables extracted from the clinical records before and after the intervention. Results: 127 patients were randomised to a nurse run clinic, of whom 106 (83%) attended. The nurse wrote 28 letters to the general practitioners suggesting changes in epilepsy management. For this intervention group compared with the usual care group there was a highly significant improvement in the level of advice recorded as having been given on drug compliance, adverse drug effects, driving, alcohol intake, and self help groups. Conclusions: Nurse run clinics for patients with epilepsy were feasible and well attended. Such clinics can significantly improve the level of advice and drug management recorded. Key messages Patients with epilepsy report that they are not given enough information about their condition and how to cope This study shows that nurse run clinics set up to provide such information and monitoring in six general practices were well attended by patients with epilepsy In more than one fifth of patients attending the clinics the nurse identified changes in aspects of drug management that could be improved The level of advice recorded as having been given on drug compliance, adverse drug effects, driving, alcohol intake, and self help groups increased significantly