Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-18T20:53:24.457Z Has data issue: false hasContentIssue false
  • English
  • Français

Burden of Epilepsy: The Ontario Health Survey

Published online by Cambridge University Press:  02 December 2014

Samuel Wiebe ,
Michael Eliasziw ,
David R. Bellhouse  and
Christine Fallahay
Samuel Wiebe
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
Michael Eliasziw
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
David R. Bellhouse
Affiliation:
Department Statistics and Actuarial Sciences, University of Western Ontario, London, Ontario, Canada
Christine Fallahay
Affiliation:
Department Statistics and Actuarial Sciences, University of Western Ontario, London, Ontario, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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

RÉSUMÉIntroduction:

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.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 26 , Issue 4 , November 1999 , pp. 263 - 270
Copyright
Copyright © The Canadian Journal of Neurological 1999

References

1. Murray, CJ, Lopez, AD, Jamison, DT. The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bull World Health Organ 1994; 72: 495–509.Google Scholar
2. Hauser, WA, Hesdorffer, DC. Incidence and Prevalence. In: Hauser, WA Hesdorffer, DC. eds. Epilepsy: frequency, causes and consequences. New York: Demos, 1990: 1–51.Google Scholar
3. Cockerell, OC, Hart, YM, Sander, JWAS, et al. The cost of epilepsyin the United Kingdom: An estimation based on the results of two population-based studies. Epilepsy Res 1994; 18: 249–260.CrossRefGoogle Scholar
4. Baker, GA, Jacoby, A, Buck, D, et al. Quality of life of people withepilepsy: a European study. Epilepsia 1997; 38: 353–362.CrossRefGoogle Scholar
5. Mossey, JM, Shapiro, E. Self-rated health: a predictor of mortalityamong the elderly. Am J Public Health 1982; 72: 800–808.CrossRefGoogle Scholar
6. Broyles, RW, Manga, P, Binder, DA, et al. The use of physicianservices under a national health insurance scheme. A n examination of the Canada Health Survey. Med Care 1983; 21: 1037–1054.CrossRefGoogle Scholar
7. Brown, EM, Goel, V. Factors related to emergency department use:results from the Ontario Health Survey 1990. Ann Emerg Med 1994; 24: 1083–1091.CrossRefGoogle ScholarPubMed
8. Ontario Health Survey 1990. Highlights. 1992; (Abstract).Google Scholar
9. Statistics Canada. Annual demographic statistics. 1997; 91-213-XPB:(Abstract).Google Scholar
10. Ontario Health Survey 1990. User’s Guide. Documentation. 1993;Vol. 1:(Abstract).Google Scholar
11. The Health of Canadians, Report of the Canada Health Survey. 1981; (Abstract).Google Scholar
12. Levasseur, M. Sources and Rationalization of Questions Used in the Quebec Health Survey. Technical Manual 87–03. 1987; 87-03:(Abstract).Google Scholar
13. Dupuy, HJ. The psychological general well-being (PGWB) index. In: Wenger, NK, Mattson, ME, Furberg, CD, et al. Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapy. New York: Le Jacq, 1984: 170–183.Google Scholar
14. Byles, J, Byrne, C, Boyle, MH, et al. Ontario Child Health Study: reliabilityand validity of the general functioning subscale of the McMaster Family Assessment Device. Fam Process 1988; 27: 97–104.Google Scholar
15. Ontario Health Survey 1990. User’s Guide. Microdata Manual. 1993; Vol. 2:(Abstract).Google Scholar
16. Rao, JN, Scott, AJ. A simple method for the analysis of clusteredbinary data. Biometrics 1992; 48: 577–585.Google Scholar
17. De Graaf, AS. Epidemiological aspects of epilepsy in Norway. Epilepsia 1974; 15: 291–299.Google Scholar
18. Baum, HM. Transient ischemic attacks, Parkinson’s disease andepilepsy: results from the 1980 National Ambulatory Medical Care Survey. Public Health 1986; 100: 368–374.CrossRefGoogle Scholar
19. Haerer, AF, Anderson, DW, Schoenberg, BS, et al. Prevalence andclinical features of epilepsy in a biracial United States population. Epilepsia 1986; 27: 66–75.CrossRefGoogle Scholar
20. Beran, RG, Michelazzi, J, Hall, L, et al. False negative response ratein epidemiologic studies to define prevalence ratios of epilepsy. Neuroepidemiology 1985; 4: 82–85.CrossRefGoogle Scholar
21. Beran, RG, Hall, L, et al. Michelazzi, J. An accurate assessment of theprevalence ratio of epilepsy adequately adjusted by influencing factors. Neuroepidemiology 1985; 4: 71–81.Google Scholar
22. Commission on Epidemiology and Prognosis: International League Against Epilepsy. Guidelines for Epidemiologic Studies on Epilepsy. Epilepsia 1993; 34: 592–596.CrossRefGoogle Scholar
23. Gudmundsson, G. Epilepsy in Iceland. A clinical andepidemiological investigation. Acta Neurol Scand 1966; 43:Suppl 25:1–124.Google Scholar
24. Stanhope, JM, Brody, JA, et al. Brink, E. Convulsions among theChamorro people of Guam, Mariana islands. I. Seizure disorders. Am J Epidemiol 1972; 95: 292–298.CrossRefGoogle ScholarPubMed
25. Austin, JK, Smith, MS, Risinger, MW, et al. Childhood epilepsy andasthma: comparison of quality of life. Epilepsia 1994; 35: 608–615.Google Scholar
26. Hermann, BP, Vickrey, B, Hays, RD, et al. A comparison of health-related quality of life in patients with epilepsy, diabetes and multiple sclerosis. Epilepsy Res 1996; 25: 113–118.CrossRefGoogle ScholarPubMed
27. Steinhoff, BJ, Neususs, K, Thegeder, H, et al. Leisure time activityand physical fitness in patients with epilepsy. Epilepsia 1996; 37: 1221–1227.CrossRefGoogle Scholar
28. Katz, SJ, Hofer, TP. Socioeconomic disparities in preventive carepersist despite universal coverage. Breast and cervical cancer screening in Ontario and the United States. JAMA 1994; 272: 530–534.Google Scholar
29. Katz, SJ, Hofer, TP, et al. Manning, WG. Physician use in Ontario andthe United States: the impact of socioeconomic status and healthstatus. Am J Public Health 1996; 86: 520–524.CrossRefGoogle Scholar
30. Badley, EM, Rasooly, I, et al. Webster, GK. Relative importance ofmusculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol 1994; 21: 505–514.Google Scholar
31. To, T, Wu, K. Health care utilization and disability of migraine: the Ontario Health Survey. Can J Public Health 1995; 86: 195–199.Google ScholarPubMed
32. Ostbye, T, Pomerleau, J, Speechley, M, et al. Correlates of body massindex in the 1990 Ontario Health Survey. Can Med Assoc J 1995; 152: 1811–1817.Google Scholar
33. Kirk Gardner, R, Steven, D. An analysis of the Ontario Health Surveyfrom a cardiovascular perspective. Can J Cardiovasc Nurs 1994; 5: 7–14.Google Scholar
34. Mariani, E, Ferini-Strambi, L, Sala, M, et al. Epilepsy ininstitutionalized patients with encephalopathy: clinical aspects and nosological considerations. Am J Ment Retard 1993; 98Suppl:27–33.Google Scholar
35. Shepherd, C, Hosking, G. Epilepsy in schoolchildren withintellectual impairments in Sheffield: the size and nature of the problem and the implications for service provision. J Ment Defic Res 1989; 33: 511–514.Google Scholar
36. Whitman, S, Coleman, TE, Patmon, C, et al. Epilepsy in prison:elevated prevalence and no relationship to violence. Neurology 1984; 34: 775–782.Google Scholar
37. Sillanpaa, M. Social functioning and seizure status of young adultswith onset of epilepsy in childhood. An epidemiological 20-year follow-up study. Acta Neurol Scand 1983; 96: 1–81.Google Scholar
38. Thompson, PJ, Upton, D. Quality of life in family members ofpersons with epilepsy. In: Trimble, MR Dodson, WE. eds. Epilepsy and Quality of Life. New York: Raven Press Ltd. 1994: 19–31.Google Scholar
39. Ross, CE, Hayes, D. Exercise and psychologic well-being in thecommunity. Am J Epidemiol 1988; 127: 762–771.Google Scholar
40. Begley, CE, Annegers, JF, Lairson, DR, et al. Cost of epilepsy in theUnited States: a model based on incidence and prognosis. Epilepsia 1994; 35: 1230–1243.Google Scholar
41. Robinson, R. Costs and cost-minimisation analysis. Br Med J 1993; 307: 726–728.Google Scholar
42. Tennis, P, Cole, TB, Annegers, JF, et al. Cohort study of incidence ofsudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada. Epilepsia 1995; 36: 29–36.Google Scholar
43. Jobe, JB, White, AA, Kelley, CL, et al. Recall strategies and memoryfor health-care visits. Milbank Q 1990; 68: 171–189.Google Scholar
44. Taylor, MP, Readman, S, Hague, B, et al. A district epilepsy service,with community-based specialist liaison nurses and guidelines for shared care. Seizure 1994; 3: 121–127.Google Scholar