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Hand-held computer to improve patient care in Epilepsy Patients?

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Anti-epileptic medications often cause unwanted side-effects, particularly during drug or dose changes. Patients can usually only address these effects at follow-up meetings with their neurologists, and consequently spend weeks or months with a decreased quality of life.

Fortunately this might not be the case for much longer. Researchers in Freiberg, Germany, are developing a personal digital assistant (PDA), a type of hand-held computer, which will allow patients to send regular updates to their specialist about their physical and mental well-being, without having to wait for a hospital appointment. It is hoped that, in this way, problems during drug / dose changes will be detected early and appropriate action taken promptly.

A pilot study for the PDA showed promising results. In this study, 20 adults with epilepsy were recruited. 10 were kept on constant medication (this was the control / comparison group), whilst the other 10 were given an add-on drug on top of their usual treatment. Over the course of six days, the patients were asked to self-assess their level of aggression, their physical well-being and their mental functioning, three times per day, and record the details using the PDA programme.

When the results were examined, it could be seen that very soon after the start of the study, the people in the add-on group reported that they felt more aggressive compared to before, and that their level of aggression increased in intensity over the six days. This was not the case in the control group.

In addition, it could be clearly seen that highest levels of aggression felt by the add-on group were early in the afternoon.

The PDA, therefore, successfully allowed changes in the patients' well-being to be monitored, without the need for one-one consultations. However it is not clear from this study whether the different groups knew if they were taking an add-on treatment, which may influence the outcome of the investigation. In order to obtain unbiased results, study participants must be unaware of the group in which they have been placed.

In summary, more studies need to be performed, but the device has the potential to improve patient care in the transition between drugs and drug doses, by encouraging the early detection and tackling of side-effects.

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