강원 지역 장미회 진료 간질환자의 항경련제 복약 관행에 관한 연구

A S tudy on E pileptics’ A nticonvulsant Use in K angwondo Area

Using structured questionaire and reviewing medical records, the behavior of epileptics’ anticonvulsant use was investigated. The subjects were 159 epileptic outpatients. Most of them have received clinical care with anticonvulsants at the Rose Club from Jaunary 1 to June 30, 1989 in Wonju Christian Hospital. The results were as follow ; 1) The first choice of treatment behavior after symptom onset was**visiting hospital” (57.9 %), followed by “herbal medication” (15.7%) and “visiting drug store (14.5%). 2) The time interval between the symptom onset and the start of medication was abetween 1 and 10 Years” (3 6 .5 ^ ), followed by “within 1 year” (33.3쩟) and “immediately” (18. 2 %) . 3) The seizures were controlled very well with medication in 74.8%, but 6.9% of the subjects reported “aggrevated”. 4) 73.6% of the subjects were regularly followed up. The reason of irregular follow-up was “misinterpretation as complete remission” (1 8 .8 ^ ), followed by “financial burden for the drug” (9.3% ) and “doubt of drug effect” (9.3% ). 5) The predisposed factor of recurrence after medication was “fatigue” ( 2 4 .8 0 , followed by “stopping medication” (21.9%) and “stress” (1 4 .3 ^ ). 6) The main source of anticonvulsant was “OPD by patient himself(herself)” (4 9 .7 ^,) followed by “mobile clinic ”and “OPD by patient’s relative”. 7) 41.6% of the subjects didn’t visit at the day of the study because of “busyness” . 8) Most of the subject have experienced no side effect ever, followed by G-I trouble. 9) Common difficulty in regular medication was strict observance of time(l5.7%), followed by carrying with medicine(2.5%). 10) The correlation between variables related with anticonvulsants use was tested by chisquare. (1) The rate of “regular medication”was higher in patients with longer period of prescription at time. (2) The rate of “discontinuance of medicine with patient’s own will” was higher in the patient group of OPD visit by other than patient himself. (3) The side effect of anticonvulsant was more frequently complained in the group of hi gher education. With these results, the style of anticonvulsant use in a rural Kangwondo area was discussed and compared with other studies. Also, it was discussed how current practice of the Rose Club for epileptics should be modified with the emergence of more comprehensive medical insurance system, and how epilepsy can be managed in psychatiric practice in longterm basis.