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Burden of Epilepsy: The Ontario Health Survey

  • Samuel Wiebe (a1) (a2), Michael Eliasziw (a1) (a2), David R. Bellhouse (a3) and Christine Fallahay (a3)

Abstract

Background:

Few data exist on the frequency and burden of epilepsy in Canada and on the impact of self-reported epilepsy in the general population. We assess the frequency, general health, psychosocial function, and health care resource use among self-identified epileptic persons in the general population.

Method:

The 1990 Ontario Health Survey is an omnibus, extensive health survey of 61,239 subjects representing the Ontario population. Self-reported epileptic subjects are compared with three groups, ie., those with ≥1 other chronic illnesses, the general population, and those with no health problems.

Results:

The point prevalence of self-reported epilepsy was 5.8 per 1,000 population, a figure similar to that of active epilepsy in other studies. Quality of life, family function and social support were worse in epileptic than in other chronically ill subjects. Similarly, the epilepsy population had more disability days and limitations in activities, and lower annual income than all other groups, including the chronically ill. Accidents were no more common among epileptic subjects than among controls. Epileptic persons were high users of health care resources, including hospitalization, emergency room, psychological/social work, nursing services and telephone contact with health professionals. Barriers to health care were experienced infrequently. Small area variations in health status and care are explored.

Conclusion:

The health profile of self-reported epileptic subjects is similar to that obtained in studies involving defined epilepsy patients. In the general population, self-identification as having epilepsy carries a significant burden of illness, reflected in poorer health, psychosocial function, and quality of life, and higher health care resource use.

RÉSUMÉ Introduction:

Il existe peu de données sur la prévalence et le fardeau de l’épilepsie au Canada et sur l’impact de l’épilepsie rapportée par le patient dans la population en général. Nous avons évalué la prévalence, la santé en général, la function psychosociale et l’utilisation des services de santé chez des personnes qui se sont déclarées épileptiques dans la population en général.

Méthodes:

L’enquête ontarienne sur la santé faite en 1990 est une enquête universelle, extensive sur la santé de 61,239 personnes représentatives de la population de l’Ontario. Les personnes qui se sontdéclarées épileptiques ont été comparées à 3 groupes, soit celles qui ont e 1 autre maladie chronique, la population en général et celles qui n’ont pas de problème de santé.

Résultats:

La prévalence de l’épilepsie rapportée par l’individu était de 5.8 par 1,000 individus, un nombre équivalent à celui rapporté pour l’épilepsie active dans d’autres études. La qualité de vie, la fonction familiale et le support social étaient moins bons chez les épileptiques que chez les autres personnes ayant une maladie chronique. De plus, la population épileptique avait plus de jours d’invalidité et plus de restrictions des activités et un revenu annuel moindre que les autres groupes incluant les personnes souffrant de maladies chroniques. Les accidents n’étaient pas plus fréquents chez les épileptiques que chez les contrôles. Les épileptiques utilisaient beaucoup les services de santé, incluant l’hospitalisation, les services d’urgence, de psychologie/travail social, les soins infirmiers et les contacts téléphoniques avec les professionnels de la santé. Ils rapportaient peu de barrières à l’accès aux soins de santé. De petites variations régionales dans l’état de santé et dans les soins sont explorées.

Conclusions:

Le profil de santé des personnes qui se sont déclarées épileptiques est semblable à celui qui a été obtenu dans d’autres études sur des patients ayant un diagnostic d’épilepsie. Dans la population en général, le fardeau de la maladie est important chez les personnes s’identifiantcomme épileptiques, ce qui reflète un moins bon état de santé, de fonction psychosociale et de qualité de vie et une plus grande utilisation des ressources en matière de soins de santé.

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