Medical experts’ opinion on organizing specialized medical aid for children with epilepsy and convulsive disorders in zabaykalsky krai

Full article

Goal of the research is to assess medical and social factors in the system of organizing medical aid for children with epilepsy in Zabaykalsky Krai with the participation of medical experts. Research methods and data: questionnaire data from 24 medical experts in Zabaykalsky Krai was analyzed. Findings. According to the medical experts, condition of specialized medical aid for patients with epilepsy and convulsive disorders in Zabaykalsky Krai at the present time based on compliance with the standard of care (100,0 %) and availability of drugs in chemists shops (95,8%) appears satisfactory and good. According to the medical experts, the weakest spot of the current organization of medical aid is interaction with social services (33,3%, low estimate). Epileptologist’s consultation is necessary in all cases; otolaryngologist’s consultation is the least needed by the patients (54,2 %, low estimate). Additional diagnostic techniques, which are needed by the greater part of the patients: electroencephalography (EEG) (95,8%), plain brain magnetic resonance imaging (MRI) (91,7%). The medical experts consider conducting regular long-term antiepileptic therapy the most significant arrangement (87,5%) among those necessary to improve treatment outcomes and to improve the quality of life of patients with epilepsy. Conclusion. According to the medical experts, the current organization of specialized medical aid for children with epilepsy and convulsive disorders in Zabaykalsky Krai based on compliance with the standard of care and availability of drugs is good and satisfactory. Condition of interaction of the organization of specialized medical aid with social services has been evaluated as unsatisfactory. The medical experts consider epileptologist the most essential specialist in the context of treatment for children with epilepsy and convulsive disorders. Demand for comprehensive treatment (incl. consultations of neurologist, epileptologist and psychiatrist) amounts to 20,84 %. Regular longterm antiepileptic medication is the basic arrangement for improvement of treatment outcomes and improvement of the quality of life of children with epilepsy and convulsive disorders.

Bibliography:
  1. Алексеева О.В., Строцкая И.Г., Шнайдер Н.А., Кантимирова Е.А., Шаповалова Е.А., Дмитриенко Д.В. Частота встречаемости синдрома обструктивного апноэ сна у детей с эпилепсией // V Юбилейный Балтийский конгресс по детской неврологии // Человек и здоровье. – 2015. – С. 5–6.
  2. Белоусова Е.Д., ЕрмаковА.Ю., Дорофеева М.Ю. и др. Дифференциальный диагноз эпилепсии / под ред. Е.Д. Белоусовой, А.Ю. Ермакова. – М.: Пульс, 2007. – 364 с.
  3. Говорина Ю.Б., Шнайдер Н.А., Дмитренко Д.В., Исаева Н.В., Евдокименко Д.В., Фатеева Е.А., Якубович Г.В. Анализ осведомленности врачей неврологов об организации медицинской помощи больным эпилепсией в Красноярском крае // Международный журнал прикладных и фундаментальных исследований. – 2015. – № 10. – С. 807–811. http://rae.ru/upfs/pdf/2015/10-5/7631.pdf.
  4. Маруева Н.А. Эпидемиология эпилепсии и судорожных синдромов в детской популяции Забайкальского края / Н.А. Маруева, Н.А. Шнайдер, А.В. Шульмин и др. // Забайкальский медицинский вестник. – 2015. – № 2. – С. 119–128.
  5. Неврология. Национальное руководство. Краткое издание / под редакцией Е.Н. Гусева, А.Н. Коновалова, А.Б. Гехт. – М.: ГОЭТАР-Медиа, 2014. – 688 с.
  6. Терскова Н.В., Вахрушев С.Г., Шнайдер Н.А., Алексеева О.В., Сидоренко Д.Р., Артемов В.В. Эффективное оториноларингологическое сопровождение больного детского возраста с аноксическим приступом // Современные проблемы науки и образования (электронный журнал). – 2015. – № 5 (61).
  7. Шнайдер Н.А., Алексеева О.В., Строцкая И.Г., Терскова Н.В., Говорина Ю.Б., Кантимирова Е.А., Дюжаков С.К. Коморбидность синдрома обструктивного апноэ/гипопноэ сна и эпилепсии у детей (пилотное исследование) // Справочник врача общей практики. – 2015. – № 10. – С. 35–40.
  8. Hauser W.A., Annegers J.F., Kurland L.T. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia.1993. 34 (3). 453–468.
  9. International League Against Epilepsy (ILAE). Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis. Epilepsia.1993. 34. 592–596.
  10. Meyer A.C., Dua T., Boscardin W.J. et al. Critical determinants of the epilepsy treatment gap: a crossnational analysis in resourcelimited setting. Epilepsia. 2012. 53. P. 2178–85.
  11. World Health Organization (WHO).Global burden and need for a coordinaited action at the country level to address its health, social and public knowledge implications. Resolution approved by the WHO Executive Board, http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_R8-en.pdfAccessed February 12.2015.
About the authors

  • A.V. Shulmin
  • GBOU VPO «Krasnoyarsk State Medical University professor V.F. Voyno-Yasenetsky», 660022, Krasnoyarsk region, Krasnoyarsk, st. Partizan Zheleznyaka, 1, doctor of medical sciences, associate professor, head of department of public health and health with the course of social work

  • G.A. Goltvanitsa
  • GUZ «Regional Children's Clinical Hospital», 672000, Chita, st. Novobulvarnaya, 20, candidate of medical sciences, head of the Trans-Baikal regional antiepileptic center

  • G.G. Baykova
  • GUZ «Regional Children's Clinical Hospital», 672000, Chita, st. Novobulvarnaya, 20, candidate of medical sciences, chief pediatric neurologist freelance Trans-Baikal Territory, the head of the neurological department

  • N.A. Maruyeva
  • GBOU VPO «Krasnoyarsk State Medical University professor V.F. Voyno-Yasenetsky», 660022, Krasnoyarsk region, Krasnoyarsk, st. Partizan Zheleznyaka, 1, candidate of medical sciences, competitor of a scientific degree of doctor of medicine department of medical genet-cs and clinical neurophysiology IPO

  • N.A. Shnayder
  • GBOU VPO «Krasnoyarsk State Medical University professor V.F. Voyno-Yasenetsky», 660022, Krasnoyarsk region, Krasnoyarsk, st. Partizan Zheleznyaka, 1, doctor of medical sciences, professor, head of the department of medical genetics and clinical neurophysiology, institute of postgraduate education, head of the neuroscience center, epileptology, neurogenetics and brain research at the university hospital

  • Y.A. Shirshov
  • GBOU VPO «Chita state medical academy», 672090, Chita, st. Gorky, 39A, candidate of medical science, professor, head of the department of neurology, neurosurgery and medical genetics

  • Y.V. Leontyeva
  • GUZ «Regional Children's Clinical Hospital», 672000, Chita, st. Novobulvarnaya, 20, candidate of medical science, neurologist-epileptolog Trans-Baikal regional center antiepileptic