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National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland

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National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland. / NANSIG Collaborative.
In: Seizure, Vol. 111, 31.10.2023, p. 165-171.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

NANSIG Collaborative 2023, 'National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland', Seizure, vol. 111, pp. 165-171. https://doi.org/10.1016/j.seizure.2023.08.010

APA

NANSIG Collaborative (2023). National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland. Seizure, 111, 165-171. https://doi.org/10.1016/j.seizure.2023.08.010

Vancouver

NANSIG Collaborative. National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland. Seizure. 2023 Oct 31;111:165-171. Epub 2023 Aug 26. doi: 10.1016/j.seizure.2023.08.010

Author

NANSIG Collaborative. / National audit of pathways in epileptic seizure referrals (NAPIER) : A national, multicentre audit of first seizure clinics throughout the UK and Ireland. In: Seizure. 2023 ; Vol. 111. pp. 165-171.

Bibtex

@article{1adbf06370ef4ec5b2bcc5bea3155496,
title = "National audit of pathways in epileptic seizure referrals (NAPIER): A national, multicentre audit of first seizure clinics throughout the UK and Ireland",
abstract = "Background: Current guidelines set clinical standards for the management of suspected first seizures and epilepsy. We aimed to assess if these standards are being met across first seizure clinics nationally, to describe variations in care and identify opportunities for service delivery improvement. Methods: Multicentre audit assessing the care of adults (≥16 years) referred to first seizure clinics from 31st December 2019 going backwards (30 consecutive patients per centre). Patients with pre-existing diagnosis of epilepsy were excluded. Anonymised referral, clinic, and follow-up data are reported with descriptive statistics. Results: Data provided for 727 patients from 25 hospitals in the UK and Ireland (median age 41 years [IQR 26–59], 52% males). Median time to review was 48 days (IQR 26–86), with 13.8% (IQR 3.3%–24.0%) of patients assessed within 2 weeks. Seizure recurrence was seen in 12.7% (IQR 6.6%–17.4%) of patients awaiting first appointment. Documentation for witness accounts and driving advice was evident in 85.0% (IQR 74.0%–100%) and 79.7% (IQR 71.2%–96.4%) of first seizure/epilepsy patients, respectively. At first appointment, discussion of sudden unexpected death in epilepsy was documented in 30.1% (IQR 0%–42.5%) of patients diagnosed with epilepsy. In epilepsy patients, median time to MRI neuroimaging was 37 days [IQR 22–56] and EEG was 30 days [IQR 19–47]. 30.4% ([IQR 0%–59.5%]) of epilepsy patients were referred to epilepsy nurse specialists. Conclusions: There is variability nationally in the documented care of patients referred to first seizure clinics. Many patients are facing delays to assessment with epilepsy specialists with likely subsequent impact on further management.",
keywords = "Epilepsy, First seizure, First seizure clinic, Seizure, Seizure mimic",
author = "{NANSIG Collaborative} and Lee, {Seong Hoon} and Conor Gillespie and Soham Bandyopadhyay and Armin Nazari and Ooi, {Setthasorn Zhi Yang} and Park, {Jay J.} and Claire Champ and Michael Kinney and Graham Mackay and Myint, {Phyo Kyaw} and Anthony Marson and Ajitesh Anand and Alena Abraham and Alex Irving and Amogh Prabhakar and Catinca Ciuculete and Cindy Zheng and Declan Browne and Barua, {Dipesh Kumar} and Dorota Duklas and Farhat Mirza and Fumilola Olaifa and Harmani Daler and Hassan Naveed and Heba Elzeky and Hedley Emsley and Honglin Zhu and Ian Morrison and Irtiza Syed and Isabel Summers and Jack Wellington and Jasmine Wall and John O'Dwyer and Jordan Ford and Karthikeyan Sivaganesh and Katja Lassak and Keara Jamison and Khalid Hamandi and Kourosh Parvi and Lareyna McMenemy and Lewis McColm and Lina Aleknaite and Maithili Srikantha and Maja Kaladjiska and Marie Jasim and Mark McCarron and Martina Mockova and Mohammad Marar and Naghme Adab and Najma Ahmed",
year = "2023",
month = oct,
day = "31",
doi = "10.1016/j.seizure.2023.08.010",
language = "English",
volume = "111",
pages = "165--171",
journal = "Seizure",
issn = "1059-1311",
publisher = "W.B. Saunders Ltd",

}

RIS

TY - JOUR

T1 - National audit of pathways in epileptic seizure referrals (NAPIER)

T2 - A national, multicentre audit of first seizure clinics throughout the UK and Ireland

AU - NANSIG Collaborative

AU - Lee, Seong Hoon

AU - Gillespie, Conor

AU - Bandyopadhyay, Soham

AU - Nazari, Armin

AU - Ooi, Setthasorn Zhi Yang

AU - Park, Jay J.

AU - Champ, Claire

AU - Kinney, Michael

AU - Mackay, Graham

AU - Myint, Phyo Kyaw

AU - Marson, Anthony

AU - Anand, Ajitesh

AU - Abraham, Alena

AU - Irving, Alex

AU - Prabhakar, Amogh

AU - Ciuculete, Catinca

AU - Zheng, Cindy

AU - Browne, Declan

AU - Barua, Dipesh Kumar

AU - Duklas, Dorota

AU - Mirza, Farhat

AU - Olaifa, Fumilola

AU - Daler, Harmani

AU - Naveed, Hassan

AU - Elzeky, Heba

AU - Emsley, Hedley

AU - Zhu, Honglin

AU - Morrison, Ian

AU - Syed, Irtiza

AU - Summers, Isabel

AU - Wellington, Jack

AU - Wall, Jasmine

AU - O'Dwyer, John

AU - Ford, Jordan

AU - Sivaganesh, Karthikeyan

AU - Lassak, Katja

AU - Jamison, Keara

AU - Hamandi, Khalid

AU - Parvi, Kourosh

AU - McMenemy, Lareyna

AU - McColm, Lewis

AU - Aleknaite, Lina

AU - Srikantha, Maithili

AU - Kaladjiska, Maja

AU - Jasim, Marie

AU - McCarron, Mark

AU - Mockova, Martina

AU - Marar, Mohammad

AU - Adab, Naghme

AU - Ahmed, Najma

PY - 2023/10/31

Y1 - 2023/10/31

N2 - Background: Current guidelines set clinical standards for the management of suspected first seizures and epilepsy. We aimed to assess if these standards are being met across first seizure clinics nationally, to describe variations in care and identify opportunities for service delivery improvement. Methods: Multicentre audit assessing the care of adults (≥16 years) referred to first seizure clinics from 31st December 2019 going backwards (30 consecutive patients per centre). Patients with pre-existing diagnosis of epilepsy were excluded. Anonymised referral, clinic, and follow-up data are reported with descriptive statistics. Results: Data provided for 727 patients from 25 hospitals in the UK and Ireland (median age 41 years [IQR 26–59], 52% males). Median time to review was 48 days (IQR 26–86), with 13.8% (IQR 3.3%–24.0%) of patients assessed within 2 weeks. Seizure recurrence was seen in 12.7% (IQR 6.6%–17.4%) of patients awaiting first appointment. Documentation for witness accounts and driving advice was evident in 85.0% (IQR 74.0%–100%) and 79.7% (IQR 71.2%–96.4%) of first seizure/epilepsy patients, respectively. At first appointment, discussion of sudden unexpected death in epilepsy was documented in 30.1% (IQR 0%–42.5%) of patients diagnosed with epilepsy. In epilepsy patients, median time to MRI neuroimaging was 37 days [IQR 22–56] and EEG was 30 days [IQR 19–47]. 30.4% ([IQR 0%–59.5%]) of epilepsy patients were referred to epilepsy nurse specialists. Conclusions: There is variability nationally in the documented care of patients referred to first seizure clinics. Many patients are facing delays to assessment with epilepsy specialists with likely subsequent impact on further management.

AB - Background: Current guidelines set clinical standards for the management of suspected first seizures and epilepsy. We aimed to assess if these standards are being met across first seizure clinics nationally, to describe variations in care and identify opportunities for service delivery improvement. Methods: Multicentre audit assessing the care of adults (≥16 years) referred to first seizure clinics from 31st December 2019 going backwards (30 consecutive patients per centre). Patients with pre-existing diagnosis of epilepsy were excluded. Anonymised referral, clinic, and follow-up data are reported with descriptive statistics. Results: Data provided for 727 patients from 25 hospitals in the UK and Ireland (median age 41 years [IQR 26–59], 52% males). Median time to review was 48 days (IQR 26–86), with 13.8% (IQR 3.3%–24.0%) of patients assessed within 2 weeks. Seizure recurrence was seen in 12.7% (IQR 6.6%–17.4%) of patients awaiting first appointment. Documentation for witness accounts and driving advice was evident in 85.0% (IQR 74.0%–100%) and 79.7% (IQR 71.2%–96.4%) of first seizure/epilepsy patients, respectively. At first appointment, discussion of sudden unexpected death in epilepsy was documented in 30.1% (IQR 0%–42.5%) of patients diagnosed with epilepsy. In epilepsy patients, median time to MRI neuroimaging was 37 days [IQR 22–56] and EEG was 30 days [IQR 19–47]. 30.4% ([IQR 0%–59.5%]) of epilepsy patients were referred to epilepsy nurse specialists. Conclusions: There is variability nationally in the documented care of patients referred to first seizure clinics. Many patients are facing delays to assessment with epilepsy specialists with likely subsequent impact on further management.

KW - Epilepsy

KW - First seizure

KW - First seizure clinic

KW - Seizure

KW - Seizure mimic

U2 - 10.1016/j.seizure.2023.08.010

DO - 10.1016/j.seizure.2023.08.010

M3 - Journal article

AN - SCOPUS:85168812785

VL - 111

SP - 165

EP - 171

JO - Seizure

JF - Seizure

SN - 1059-1311

ER -