Epilepsy Patients Have Small Increased Risk of Unnatural Death

MedicalResearch.com Interview with:

Dr Hayley Gorton PhD MPharm MRPharmS FHEA Research Associate Centre for Pharmacoepidemiology and Drug Safety Research Division of Pharmacy & Optometry| Faculty of Biology, Medicine & Health University of Manchester

Dr. Gorton

Dr Hayley Gorton PhD MPharm MRPharmS FHEA
Research Associate Centre for Pharmacoepidemiology and Drug Safety Research
Division of Pharmacy & Optometry| Faculty of Biology, Medicine & Health
University of Manchester

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is already known that people with epilepsy are at a higher risk of death than those without epilepsy but we didn’t know much about the risks of different types of death. Unnatural death (mainly accident and suicide) accounts for a very small number of all deaths but, compared to people without epilepsy, people with epilepsy are three times more likely to die by accident and twice as likely to die by suicide. Within these broad categories, persons with epilepsy are five times more likely to die specifically by accidental poisoning with medication, and three times more likely to die by intentionally poisoning themselves with medication. Opioid painkillers and medicines for mental illness were the ones most commonly used in poisoning deaths among people with epilepsy and those without epilepsy. Antiepileptic drugs were taken relatively infrequently-they were involved in about 10% of poisoning deaths in people with epilepsy. 

MedicalResearch.com: What should readers take away from your report?

Response: Although the absolute risk is low (0.3-0.5%), people with epilepsy are more likely to die from unnatural causes than people without epilepsy. Doctors, nurses and pharmacists should work with people with epilepsy and their carers to identify accident risks and any suicidal feelings or actions. They should also be mindful of the other medication they prescribe to people with epilepsy to treat other conditions that these individuals experience.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: We need to firstly understand what causes these increased risks and then develop and evaluate effective interventions that reduce them. This will require studies that apply different designs and methods to the routinely collected databases that we utilised to conduct this study. For example, it might be helpful to speak to people with epilepsy and also to their healthcare providers. 

MedicalResearch.com: Is there anything else you would like to add?

Response: We examined two large routinely collected clinical databases, the Clinical Research Practice Datalink (CPRD) linked to Office for National Statistics (ONS) mortality data in England, and the Secure Anonymised Information Linkage (SAIL) Databank in Wales. With this approach we cannot identify the causes of the increased risks reported, but instead we report associations. We urge anyone reading this interview to speak to their doctor, nurse, pharmacist or relevant support charity, if they are worried about anything that has been discussed here. This research was funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the National Health Service (NHS), National Institute for Health Research, or Department of Health.

Citations:

Gorton HC, Webb RT, Carr MJ, DelPozo-Banos M, John A, Ashcroft DM. Risk of Unnatural Mortality in People With Epilepsy. JAMA Neurol. Published online April 09, 2018. doi:10.1001/jamaneurol.2018.0333 

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