Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians

Objective To examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP. Methods Questionnaires were sen...

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Bibliographic Details
Main Authors: Strzelczyk, Adam (Author) , Schubert-Bast, Susanne (Author)
Format: Article (Journal)
Language:English
Published: Feruary 22, 2016
In: Epilepsia
Year: 2016, Volume: 57, Issue: 4, Pages: 612-620
ISSN:1528-1167
DOI:10.1111/epi.13337
Online Access:Verlag, Volltext: https://doi.org/10.1111/epi.13337
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.13337
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Author Notes:Adam Strzelczyk, Gerda Zschebek, Sebastian Bauer, Christoph Baumgartner, Martin Grond, Anke Hermsen, Matthias Kieslich, Günter Krämer, Gerhard Kurlemann, Theodor W. May, Thomas Mayer, Bernd A. Neubauer, Margarete Pfäfflin, Barbara Plecko, Philippe Ryvlin, Susanne Schubert‐Bast, Hermann Stefan, Eugen Trinka, Susanne Knake, Carola Seifart, and Felix Rosenow

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520 |a Objective To examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP. Methods Questionnaires were sent to approximately 5,000 neurologists and neuropediatricians in 2014 regarding respondents’ demographics, their working environments, and how often they discussed SUDEP, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities. Results In total, 519 surveys were completed (respondents’ mean age: 45.5 years, 41.6% female, 66.9% adult neurologists, 31.0% neuropediatricians). A minority of 2.7% reported that they counseled all of their patients on SUDEP, 8.7% counseled most of the time (50-90%), 20.8% sometimes (10-49%), 44.5% rarely (1-9%), and 23.3% reported not counseling about SUDEP at all. In contrast, 92.9% reported that they counseled all patients about driving restrictions and 81.5% about risks in daily life activities. Suicidal ideations were discussed in 59.0% for some and in 3.3% for all patients, whereas 35.1% of respondents reported never discussing suicidal ideations. Independent predictors of not discussing SUDEP were no additional epilepsy training, no or uncertain SUDEP cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in SUDEP prevention. The opinion that SUDEP is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on SUDEP. Significance Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to SUDEP or suicidality. Both are not discussed at all by a substantial proportion of neurologists and neuropediatricians. This is in contrast to ubiquitous education about driving restrictions. Dissemination of knowledge among physicians about potential preventive strategies might increase the likelihood of discussion. Clinical practice guidelines are welcomed by the majority of physicians in this process. 
650 4 |a Counseling 
650 4 |a Driving 
650 4 |a Drowning 
650 4 |a Epilepsy 
650 4 |a Sudden unexpected death in epilepsy patients 
650 4 |a Suicide 
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