Sunjay Nunley1, Peter Glynn2, Steve Rust3, Jorge Vidaurre2, Dara V F Albert2, Anup D Patel2. 1. Pediatric Neurology, Greenville Health System, 200 Patewood Drive, Suite A350, Greenville, SC 29615, United States. Electronic address: SNunley@ghs.org. 2. Division of Neurology, FB Suite 4B.3, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States. 3. Research Information Solutions & Innovation, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States.
Abstract
RATIONALE: About 20 per 100,000 children have convulsive status epilepticus every year, a life-threatening condition. Benzodiazepines are the first-line treatment for prolonged and recurrent seizures. Our study was designed to gain understanding of caregiver perception of acute seizure treatments. METHODS: Our project uses a cross-sectional survey study design using the electronic medical record and a survey at a large academic tertiary children's medical center. Subjects were patients with epilepsy prescribed intranasal (IN) midazolam and/or per rectum (PR) diazepam. The survey was administered to caregivers of children with epilepsy regarding information on the comfort, efficacy, ease of use, and time of administration for patients receiving both abortive seizure medications. Exact binomial tests were employed to determine whether or not differences in caregiver preference exist. RESULTS: One hundred and sixty responses were obtained. Incomplete and duplicate surveys were excluded, leaving 153 responses. Of those responses, 59 respondents reported administering both medications. Among parents who expressed a preference for one medication over the other, more parents felt overall greater comfort with IN midazolam compared with rectal diazepam (p = 0.0004 and p = 0.001), IN midazolam was perceived as easier to use (68%, p = 0.0038 and 74%, p = 0.0004) and more effective (87%, p < 0.0001) than rectal diazepam. Intranasal midazolam was found to be superior to rectal diazepam in several other categories as well. CONCLUSIONS: These parents of children with epilepsy report increased ease of use, comfort, and efficacy with IN midazolam as compared with rectal diazepam suggesting that a readily available form of IN midazolam would be well received in the pediatric population.
RATIONALE: About 20 per 100,000 children have convulsive status epilepticus every year, a life-threatening condition. Benzodiazepines are the first-line treatment for prolonged and recurrent seizures. Our study was designed to gain understanding of caregiver perception of acute seizure treatments. METHODS: Our project uses a cross-sectional survey study design using the electronic medical record and a survey at a large academic tertiary children's medical center. Subjects were patients with epilepsy prescribed intranasal (IN) midazolam and/or per rectum (PR) diazepam. The survey was administered to caregivers of children with epilepsy regarding information on the comfort, efficacy, ease of use, and time of administration for patients receiving both abortive seizure medications. Exact binomial tests were employed to determine whether or not differences in caregiver preference exist. RESULTS: One hundred and sixty responses were obtained. Incomplete and duplicate surveys were excluded, leaving 153 responses. Of those responses, 59 respondents reported administering both medications. Among parents who expressed a preference for one medication over the other, more parents felt overall greater comfort with IN midazolam compared with rectal diazepam (p = 0.0004 and p = 0.001), IN midazolam was perceived as easier to use (68%, p = 0.0038 and 74%, p = 0.0004) and more effective (87%, p < 0.0001) than rectal diazepam. Intranasal midazolam was found to be superior to rectal diazepam in several other categories as well. CONCLUSIONS: These parents of children with epilepsy report increased ease of use, comfort, and efficacy with IN midazolam as compared with rectal diazepam suggesting that a readily available form of IN midazolam would be well received in the pediatric population.
Authors: Marios Charalambous; Holger A Volk; Andrea Tipold; Johannes Erath; Enrice Huenerfauth; Antonella Gallucci; Gualtiero Gandini; Daisuke Hasegawa; Theresa Pancotto; John H Rossmeisl; Simon Platt; Luisa De Risio; Joan R Coates; Mihai Musteata; Federica Tirrito; Francesca Cozzi; Laura Porcarelli; Daniele Corlazzoli; Rodolfo Cappello; An Vanhaesebrouck; Bart J G Broeckx; Luc Van Ham; Sofie F M Bhatti Journal: J Vet Intern Med Date: 2019-10-03 Impact factor: 3.333