New clinical guidelines expected to help patients get the right care for epilepsy

April 2, 2015

By Deron Hamel

A prominent Toronto neurologist says the recent establishment of the Provincial Guidelines for the Management of Epilepsy in Adults and Children is an important step forward in creating consistent epilepsy care in Ontario.

300Dr. Carter Snead, a neurologist at Toronto’s Hospital for Sick Children (SickKids), says the greatest overall changes he hopes come from the guidelines, which took effect in January, are improved patient flow between primary-care physicians and specialists as well as more efficient prescription of medications.

In short, the guidelines create a framework for general practitioners to know at what point a patient experiencing symptoms related to epilepsy needs to be referred to a neurologist, Snead says. The guidelines, he adds, also help ensure appropriate medications are prescribed at appropriate times.

Prior to their creation there were no clinical guidelines for epilepsy management in Ontario. Until now, Ontario neurologists had followed guidelines established by the American Academy of Neurology. As a result, the consistency of care has varied in the province.

A critical component of the guidelines is that they outline specifically when it is appropriate to refer patients for further evaluation – if they’re not, for example, responding well to medication. The new guidelines provide the information for physicians to know when to refer patients for other treatment options.

“I’ve met people in Ontario who were finally referred to an epileptologist after years, or even decades, of struggling to cope with uncontrolled seizures,” says Epilepsy Ontario information specialist Suzanne Nurse.

“Some people were offered a new drug treatment or another therapy to control their seizures, which in some cases has resulted in seizure freedom. These guidelines, which are available on the Epilepsy Ontario website, will help people with epilepsy across the province to access the right care.”

The new guidelines are the result of the Epilepsy Implementation Information Task Force, which was established by the Ministry of Health and Long-Term Care in June 2013.

The purpose of creating the guidelines was to improve access to epilepsy care across the continuum by co-ordinating resources and wait lists for epilepsy surgery across Ontario, and to establish standardized diagnostic and surgical protocols and develop supports for primary care providers of patients with epilepsy.

Snead says the task force and organized effort by the province to enhance care and access to epilepsy specialists for people with seizure disorders stands out – and it’s getting noticed.

“(This) is really unique to my experience anywhere in North America, in terms of a government initiated effort,” Snead says. “And this is now starting to have a ripple effect throughout Canada, because I am now getting calls from all over the country from advocates and neurologists about how they can establish the same kind of advocacy in their province that we have been successful at doing here.”

Click here for information on the Provincial Guidelines for the Management of Epilepsy in Adults and Children.

Click here for information on the Provincial Strategy for Epilepsy Care.

This is Part 1 of a two-part story. Part 2 will focus on long-term results and the importance of patient and physician advocacy of these new guidelines.

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