Suboptimal anti-epilepsy drug use is common among Indigenous patients with seizures presenting to the emergency department

Abstract

We aimed to explore the causes of higher than expected rates of Indigenous emergency department (ED) seizure presentations. A questionnaire was administered to adult patients presenting with seizure to an ED in Far North Queensland. Over 15 months, among 260 presentations with seizure (22% Indigenous), 50% non-Indigenous patients, and 45% Indigenous patients completed the questionnaire. Risk factors for alcohol misuse were common in both groups (50% Indigenous, 43% non-Indigenous; p = 0.50), as were rates of reported head injury (50% Indigenous, 44% non-Indigenous; p = 0.50). However, 47% Indigenous patients, compared to 19% non-Indigenous patients ( p < 0.05) reported missing anti-epileptic tablets at least twice weekly, representing clinically relevant medication non-adherence. This was the first reported seizure presentation for 12% Indigenous patients and 26% non-Indigenous patients. We conclude that among ED seizure presentations, alcohol excess and prior head injury are commonly observed, in both Indigenous and non-Indigenous patients. However, Indigenous patients have higher rates of anti-convulsant non-adherence, likely contributing to ED presentations.