Abstract
This study aims to determine the comprehensiveness of pediatric epilepsy outpatient
clinic letters in a tertiary pediatric neurology center with particular focus on the
prescribing instructions. A retrospective study was conducted for all pediatric outpatient
epilepsy clinic letters between August and October 2016. This study was undertaken
in a tertiary pediatric neurology department at the Bristol Royal Hospital for Children,
United Kingdom. A total of 160 patients were identified during the time period and
included in the study. Letters were evaluated for the following information: patient
demographics, inclusion of problem list, and medication details including the clarity
of prescribing instructions. The comprehensiveness of letters was scored out of nine
based on the nine categories; weight, diagnosis list, medication list, dose in milligrams,
dose equivalence in milligrams/kilograms/day, formulation, strength or concentration
of medication, if applicable is the volume of medication provided and is the trade
name provided. A total of 94% of letters had a diagnosis or problem list provided
which was clear. Only 68% letters had a separate medication list provided. The dose
of antiepileptic drugs (AEDs) in milligrams was provided in 95% of letters. The formulation
of the AED was provided in only 30% of letters. Only 24% of letters where a category
1 AED was prescribed had the trade name provided. This study has demonstrated significant
omissions from outpatient pediatric epilepsy letters. The omissions presented in this
study may culminate in inefficient communication and increased morbidity. We share
practice improving learning points for writing comprehensive letters which we believe
can be generalized to other pediatric specialties.
Keywords
outpatient letter - epilepsy - antiepileptic drugs - prescribing - pediatrics
