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From the Department of Neurology (Drs. Gilliam, Fessler, and Attarian, V. Vahle and J. Carter), Washington University, St. Louis, MO; and University Department of Neurosciences (Dr. Baker), Liverpool, UK.
Address correspondence and reprint requests to Dr. Frank Gilliam, Washington University Epilepsy Program, Box 8111, 660 South Euclid Avenue, St. Louis, MO 63110; e-mail: gilliamf{at}neuro.wustl.edu
Objective: To determine the effectiveness of systematic screening with a brief 19-item self-report instrument, the Adverse Events Profile (AEP), to reduce adverse effects of antiepileptic drugs (AEDs) and improve subjective health status.
Methods: The authors performed a prospective randomized trial comparing the use of the AEP with usual care without the AEP. Sixty-two patients with an AEP score of 
45 were enrolled from a consecutive group of 200 consenting adults with epilepsy.
Results: The mean percent improvement in AEP scores was greater in the patient group for which clinicians received the AEP compared with the usual care group (25% vs 5%; p < 0.01). Mean change in Quality of Life in Epilepsy Inventory (QOLIE)-89 total scores was not different between groups, but for the entire sample QOLIE-89 change was greater for patients having a 15-point improvement in AEP scores than for those with a 0- to 15-point improvement or a worsened score (24 vs 12 vs 3; analysis of variance, p < 0.008). More patients in the AEP group had a >15-point improvement in QOLIE-89 score (p < 0.03). Use of the AEP was associated with a 2.8-fold increase (95% CI, 1.7 to 4.8) in AED modifications. No difference in seizure rates was observed. Conclusions: Systematic screening for antiepileptic drug side effects may increase identification of toxicity and guide medication changes to reduce adverse effects and possibly improve subjective health status.
Received April 16, 2003. Accepted in final form September 17, 2003.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the January 13 issue to find the title link for this article.
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