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Introduction: Seizures are scary phenomena but are quite common especially among children: about 8% will have had at least one seizure by 15 years of age. Most acute seizures in children are brief, terminating spontaneously and do not need any treatment. Seizures that persist beyond 5 min may not stop spontaneously and necessitate comprehensive clinical evaluation and medical care. Seizure control then becomes a matter of urgency for the patient and his family, as the longer the duration of the seizure, the greater the bad effects on body systems especially the brain and the more difficult control is likely to become. Methods: A retrospective, multicenter clinical audit was undertaken simultaneously at the three largest centers for epilepsy management in Gaza. A total of 190 medical records were included in our audit from January 1, 2017, to April 30, 2018. Aims and Objectives: Our audit aims to evaluate the care provided for patients with epilepsy from diagnosis to treatment and follow-up and to compare it against the latest National Institute for Health and Care Excellence (2017) guidelines and AACC (American Association for Clinical Chemistry) (January 7, 2018). Results: Among 190 reviewed medical records, 61% patients were males and the median age was 9 ranging from 6 to 13 years. 31.5% (n = 60) of cases suffered from various comorbidities. The overall adherence of health care professionals to audit standards was moderate. There was severe dearth of information in the medical records. Most records (n = 147, 77.4%) did not include the seizure type, frequency, and duration. Drug therapy was inconsistent with seizure type in 16 cases (8.4%). Investigations were underutilized generally. There were marked differences in the practice among health care centers. Conclusion: The vast majority of files (n = 138, 72.6%) suffered from poor documentation of seizure type, frequency, and duration which needs to be improved. Drug prescription was inconsistent and highly variable and dependent on the treating doctor’s memory and diligence. Moreover, electroencephalogram, electrocardiogram, and drug level testing were highly suboptimal. Health professionals should modify and adopt the AACC recommendations to improve diagnostic and therapeutic service and reduce potential complications and sufferings of epileptic patients. |
