Data collection tool for Epilepsy: pharmacological treatment by seizure type Complete one form for each patient. Patient identifier: Sex: Age: Organisation/service: Ethnicity: White Mixed Asian or Asian British Black or Black British Other British White and Indian Caribbean Chinese Black Caribbean Irish White and Pakistani African Any other Black African ethnic group Any other White White and Bangladeshi Any other Black Not stated background Asian background Any other mixed Any other Asian background background Data NA/ No. item Criteria Yes No Exceptionsa no. Tonic or atonic seizures 20 20.1 Was sodium valproate offered as first-line treatment? If sodium valproate was ineffective or not tolerated, was lamotrigine 21 21.1 offered as adjunctive treatment? If adjunctive treatment was ineffective or not tolerated, was the 22 22.1 treatment discussed with a tertiary epilepsy specialist? patient’s If yes, did the tertiary epilepsy specialist prescribe any of the following? 22.2 rufinamide 22.3 topiramate 22.4 other 23 Were any of the following offered? 23.1 carbamazepine 23.2 gabapentin 23.3 oxcarbazepine 23.4 pregabalin 23.5 tiagabine 23.6 vigabatrin. a Circle exception codes as appropriate. Details of exceptions are listed at the end of the patient data collection tool.
Data collection tool for Epilepsy: pharmacological treatment by seizure type Complete one form for each patient. Patient identifier: Sex: Age: Organisation/service: Ethnicity: White Mixed Asian or Asian British Black or Black British Other British White and Black Caribbean Indian Caribbean Chinese Irish White and Black African Pakistani African Any other ethnic group Any other White background White and Asian Bangladeshi Any other Black background Not stated Any other mixed background Any other Asian background No. Data item no. Criteria Yes No NA/ Exceptionsa Tonic or atonic seizures 20 20.1 Was sodium valproate offered as first-line treatment? 21 21.1 If sodium valproate was ineffective or not tolerated, was lamotrigine offered as adjunctive treatment? 22 22.1 If adjunctive treatment was ineffective or not tolerated, was the patient’s treatment discussed with a tertiary epilepsy specialist? If yes, did the tertiary epilepsy specialist prescribe any of the following? 22.2 rufinamide 22.3 topiramate 22.4 other 23 Were any of the following offered? 23.1 carbamazepine 23.2 gabapentin 23.3 oxcarbazepine 23.4 pregabalin 23.5 tiagabine 23.6 vigabatrin. a Circle exception codes as appropriate. Details of exceptions are listed at the end of the patient data collection tool.
Epilepsy-%20pharmacological%20treatment%20by%20seizure%20type.docx