Attitudes of GPs to the care of people with epilepsy

BACKGROUND: Most individuals with current epilepsy are solely under thecare of the primary care team for follow-up care. Government working partyrecommendations, expert epilepsy panels and patients have also stressed thecentral role of the GP in follow-up care. Problems in the provision of carein the community have, however, repeatedly been highlighted. The views ofGPs about service provision for people with epilepsy may be an importantbarrier to providing care, but have not yet been studied in a systematicmanner. OBJECTIVES: We aimed to ascertain the views of GPs on serviceprovision for people with epilepsy in primary care and on specificinitiatives to improve care. METHOD: A specially designed postalquestionnaire was sent to all 262 GPs on the list of West Glamorgan FHSA.It ascertained what GPs felt their role should be in providing care topeople with epilepsy, identified their views on the importance ofparticular problems in providing this care, as well as obtaining theiropinions on possible future initiatives to improve epilepsy care in thecommunity. RESULTS: The overall response rate was 70%. Although a majorityof responding GPs (55%) agreed that the care of people with epilepsy shouldbe based in general practice, 23% disagreed. A lack of confidence aboutknowledge of epilepsy (34% responders), unfamiliarity with new drugs (65%responders) and a lack of time (41% responders) were identified asimportant perceived barriers to providing epilepsy care. Nearly allresponding GPs would welcome guidelines for epilepsy care (93% felt theywould be very helpful) and an epilepsy liaison nurse in the community wasthe most popular option in terms of preferred overall strategy forimproving care. CONCLUSIONS: Despite 40 years of official recommendationsregarding the central role of the GP in the follow-up care of people withepilepsy, a number of GPs have difficulty in providing this care. Many feelthat they lack knowledge or are too time pressured to improve thesituation. Nearly all GPs say that they would find guidelines for epilepsycare very helpful and over half would find epilepsy liaison nurses helpful.There is scope for more innovative ideas for epilepsy care in thecommunity.