Clinical services for adults with an intellectual disability and epilepsy: A comparison of management alternatives

Adam P. Wagner; Tim J. Croudace; Naomi Bateman; Mark W. Pennington; Elizabeth Prince; Marcus Redley; Simon R. White; Howard Ring

doi:10.1371/journal.pone.0180266

Clinical services for adults with an intellectual disability and epilepsy: A comparison of management alternatives

Adam P. Wagner, Tim J. Croudace, Naomi Bateman, Mark W. Pennington, Elizabeth Prince, Marcus Redley, Simon R. White, Howard Ring (Lead / Corresponding author)

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

256 Downloads (Pure)

Abstract

Background: Intellectual disability (ID) is relatively common in people with epilepsy, with prevalence estimated to be around 25%. Surprisingly, given this relatively high frequency, along with higher rates of refractory epilepsy than in those without ID, little is known about outcomes of different management approaches/clinical services treating epilepsy in adults with ID-we investigate this area.

Materials & Methods: We undertook a naturalistic observational cohort study measuring outcomes in n = 91 adults with ID over a 7-month period (recruited within the period March 2008 to April 2010). Participants were receiving treatment for refractory epilepsy (primarily) in one of two clinical service settings: community ID teams (CIDTs) or hospital Neurology services.

Results: The pattern of comorbidities appeared important in predicting clinical service, with Neurologists managing the epilepsy of relatively more of those with neurological comorbidities whilst CIDTs managed the epilepsy of relatively more of those with psychiatric comorbidities. Epilepsy-related outcomes, as measured by the Glasgow Epilepsy Outcome Scale 35 (GEOS-35) and the Epilepsy and Learning Disabilities Quality of Life Scale (ELDQoL) did not differ significantly between Neurology services and CIDTs.

Discussion: In the context of this study, the absence of evidence for differences in epilepsy-related outcomes amongst adults with ID and refractory epilepsy between mainstream neurology and specialist ID clinical services is considered. Determining the selection of the service managing the epilepsy of adults with an ID on the basis of the skill sets also required to treat associated comorbidities may hence be a reasonable heuristic.

Original language	English
Article number	e0180266
Pages (from-to)	1-12
Number of pages	12
Journal	PLoS ONE
Volume	12
Issue number	7
DOIs	https://doi.org/10.1371/journal.pone.0180266
Publication status	Published - 3 Jul 2017

Access to Document

10.1371/journal.pone.0180266Licence: CC BY

Final Published Version
© 2017 Wagner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Final published version, 3.06 MBLicence: CC BY

Croudace, Tim
- Health Sciences - Professor of Applied Health Research
Person: Academic

Cite this

@article{571277ba516340d1a66eb46c5f6b66c7,

title = "Clinical services for adults with an intellectual disability and epilepsy: A comparison of management alternatives",

abstract = "Background: Intellectual disability (ID) is relatively common in people with epilepsy, with prevalence estimated to be around 25%. Surprisingly, given this relatively high frequency, along with higher rates of refractory epilepsy than in those without ID, little is known about outcomes of different management approaches/clinical services treating epilepsy in adults with ID-we investigate this area.Materials & Methods: We undertook a naturalistic observational cohort study measuring outcomes in n = 91 adults with ID over a 7-month period (recruited within the period March 2008 to April 2010). Participants were receiving treatment for refractory epilepsy (primarily) in one of two clinical service settings: community ID teams (CIDTs) or hospital Neurology services.Results: The pattern of comorbidities appeared important in predicting clinical service, with Neurologists managing the epilepsy of relatively more of those with neurological comorbidities whilst CIDTs managed the epilepsy of relatively more of those with psychiatric comorbidities. Epilepsy-related outcomes, as measured by the Glasgow Epilepsy Outcome Scale 35 (GEOS-35) and the Epilepsy and Learning Disabilities Quality of Life Scale (ELDQoL) did not differ significantly between Neurology services and CIDTs.Discussion: In the context of this study, the absence of evidence for differences in epilepsy-related outcomes amongst adults with ID and refractory epilepsy between mainstream neurology and specialist ID clinical services is considered. Determining the selection of the service managing the epilepsy of adults with an ID on the basis of the skill sets also required to treat associated comorbidities may hence be a reasonable heuristic.",

author = "Wagner, {Adam P.} and Croudace, {Tim J.} and Naomi Bateman and Pennington, {Mark W.} and Elizabeth Prince and Marcus Redley and White, {Simon R.} and Howard Ring",

note = "This paper presents independent research funded by the National Institute for Health Research (NIHR - www.nihr.ac.uk) under its Research for Patient Benefit (RfPB - https://www.nihr.ac.uk/funding-and-support/funding-for-research-studies/funding-programmes/research-for-patient-benefit/) Programme (Grant PB-PG-0706-10051; PI Dr H Ring). During the time that this research was carried out, AP Wagner, TJ Croudace, M Redley and H Ring also received support from the NIHR CLAHRC for Cambridgeshire and Peterborough (http://clahrc-cp.nihr.ac.uk/). In preparing this manuscript AP Wagner and H Ring received support from the NIHR Collaboration for Leadership in Applied Health Research and Care East of England at the Cambridgeshire and Peterborough NHS Foundation Trust (http://www.clahrc-eoe.nihr.ac.uk/). SR White was supported by the Medical Research Council (Unit Programme no. U105292687 - http://www.mrc.ac.uk/).",

year = "2017",

month = jul,

day = "3",

doi = "10.1371/journal.pone.0180266",

language = "English",

volume = "12",

pages = "1--12",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "7",

}

TY - JOUR

T1 - Clinical services for adults with an intellectual disability and epilepsy

T2 - A comparison of management alternatives

AU - Wagner, Adam P.

AU - Croudace, Tim J.

AU - Bateman, Naomi

AU - Pennington, Mark W.

AU - Prince, Elizabeth

AU - Redley, Marcus

AU - White, Simon R.

AU - Ring, Howard

N1 - This paper presents independent research funded by the National Institute for Health Research (NIHR - www.nihr.ac.uk) under its Research for Patient Benefit (RfPB - https://www.nihr.ac.uk/funding-and-support/funding-for-research-studies/funding-programmes/research-for-patient-benefit/) Programme (Grant PB-PG-0706-10051; PI Dr H Ring). During the time that this research was carried out, AP Wagner, TJ Croudace, M Redley and H Ring also received support from the NIHR CLAHRC for Cambridgeshire and Peterborough (http://clahrc-cp.nihr.ac.uk/). In preparing this manuscript AP Wagner and H Ring received support from the NIHR Collaboration for Leadership in Applied Health Research and Care East of England at the Cambridgeshire and Peterborough NHS Foundation Trust (http://www.clahrc-eoe.nihr.ac.uk/). SR White was supported by the Medical Research Council (Unit Programme no. U105292687 - http://www.mrc.ac.uk/).

PY - 2017/7/3

Y1 - 2017/7/3

N2 - Background: Intellectual disability (ID) is relatively common in people with epilepsy, with prevalence estimated to be around 25%. Surprisingly, given this relatively high frequency, along with higher rates of refractory epilepsy than in those without ID, little is known about outcomes of different management approaches/clinical services treating epilepsy in adults with ID-we investigate this area.Materials & Methods: We undertook a naturalistic observational cohort study measuring outcomes in n = 91 adults with ID over a 7-month period (recruited within the period March 2008 to April 2010). Participants were receiving treatment for refractory epilepsy (primarily) in one of two clinical service settings: community ID teams (CIDTs) or hospital Neurology services.Results: The pattern of comorbidities appeared important in predicting clinical service, with Neurologists managing the epilepsy of relatively more of those with neurological comorbidities whilst CIDTs managed the epilepsy of relatively more of those with psychiatric comorbidities. Epilepsy-related outcomes, as measured by the Glasgow Epilepsy Outcome Scale 35 (GEOS-35) and the Epilepsy and Learning Disabilities Quality of Life Scale (ELDQoL) did not differ significantly between Neurology services and CIDTs.Discussion: In the context of this study, the absence of evidence for differences in epilepsy-related outcomes amongst adults with ID and refractory epilepsy between mainstream neurology and specialist ID clinical services is considered. Determining the selection of the service managing the epilepsy of adults with an ID on the basis of the skill sets also required to treat associated comorbidities may hence be a reasonable heuristic.

AB - Background: Intellectual disability (ID) is relatively common in people with epilepsy, with prevalence estimated to be around 25%. Surprisingly, given this relatively high frequency, along with higher rates of refractory epilepsy than in those without ID, little is known about outcomes of different management approaches/clinical services treating epilepsy in adults with ID-we investigate this area.Materials & Methods: We undertook a naturalistic observational cohort study measuring outcomes in n = 91 adults with ID over a 7-month period (recruited within the period March 2008 to April 2010). Participants were receiving treatment for refractory epilepsy (primarily) in one of two clinical service settings: community ID teams (CIDTs) or hospital Neurology services.Results: The pattern of comorbidities appeared important in predicting clinical service, with Neurologists managing the epilepsy of relatively more of those with neurological comorbidities whilst CIDTs managed the epilepsy of relatively more of those with psychiatric comorbidities. Epilepsy-related outcomes, as measured by the Glasgow Epilepsy Outcome Scale 35 (GEOS-35) and the Epilepsy and Learning Disabilities Quality of Life Scale (ELDQoL) did not differ significantly between Neurology services and CIDTs.Discussion: In the context of this study, the absence of evidence for differences in epilepsy-related outcomes amongst adults with ID and refractory epilepsy between mainstream neurology and specialist ID clinical services is considered. Determining the selection of the service managing the epilepsy of adults with an ID on the basis of the skill sets also required to treat associated comorbidities may hence be a reasonable heuristic.

U2 - 10.1371/journal.pone.0180266

DO - 10.1371/journal.pone.0180266

M3 - Article

C2 - 28671982

SN - 1932-6203

VL - 12

SP - 1

EP - 12

JO - PLoS ONE

JF - PLoS ONE

IS - 7

M1 - e0180266

ER -

Clinical services for adults with an intellectual disability and epilepsy: A comparison of management alternatives

Abstract

Access to Document

Fingerprint

Profiles

Croudace, Tim

Cite this