INTRODUCTION
In patients with brain tumours, seizures are common. 90% of patients with gangliogliomas and DNET tumours and 80% of patients with diffused low-grade gliomas could experience seizures at some point during their disease. Whereas, 50% of patients with high-grade glioma could develop seizures. This leads to a large neurology workload which is managed at Kings College Hospital (KCH) by an integrated service of a Neurologist and Clinical Nurse Specialists.
OBJECTIVE
To examine the practice provided to patients with tumour related epilepsy by the integrated service at KCH and assess how our service benefits patients, avoids GP/A&E visits and reduces hospital admissions.
METHOD
Four-month data collection grouped and presented into categories.
RESULTS
86 patients had contact with the integrated neuro-oncology team regarding neurology needs from 1 November 2016 to 28 February 2017:
51% required review in clinic only
15% required a clinic review with email/telephone input
34% were supported via email/telephone input alone
21% required more than one visit
31% had a diagnosis of a low-grade glioma, 22% of a high-grade glioma, 22% of a meningioma
14% attended A&E/admitted to hospital despite our advice
Of those patients supported by email/telephone alone:
78% were contacted by telephone, 22% via email
63% reported seizure activity, 37% had medication queries
29% attended A&E/admitted to hospital despite our advice
71% avoided hospital/GP appointments and/or attending A&E
CONCLUSION
Tumour related epilepsy data provided from a large neuro-oncology service at KCH is worthy of being shared. It can highlight the importance of an integrated neuro-oncology service which is accessible to patients through various means: email, telephone, clinics. A personalized service adjusted to the needs of patients.
Moreover by utilising the expertise of the Neurologist we have shown that an integrated service may reduce the use of hard-pressed NHS resources in primary care settings and within hospitals.
