The effect of specially trained epilepsy nurses in primary care: a review

The paper describes the evidence on potential effects of specially trained nurses working in primary care for patients with epilepsy. The method used was a search and review of evidence published from 1992 to 1999. It was found that where nurses have been trained in epilepsy care, there is good evidence that it is feasible for them to set up and run clinics in family practice. Where this has been undertaken, there is level I evidence that this is acceptable and satisfactory to patients. Where clinics have been set up in primary care, there is level I evidence that there has been an increase in the information and advice recorded as being provided to patients. Structured checklists may additionally prompt service providers to increase the level of information provided to patients, and this hypothesis is being tested currently. In conclusion, epilepsy nurses can set up clinics for patients in primary care which are well attended, satisfy patients, and which are associated with better recording of advice given. There is little published evidence on outcome as opposed to process measures. Trials with adequate sample size and long-term follow-up are necessary to identify whether nurse monitoring with advice and counselling can benefit patients in terms of epilepsy self-management in the long run.