The purpose of this audit is to enhance patient care by guaranteeing that all those who have been prescribed novel antiepileptic drugs (AEDs) are appropriately and fully informed of possible side effects. Open communication and education of patients are vital aspects of quality healthcare, especially in dealing with chronic ailments like epilepsy. Educating the patient about the treatment clearly will enable them to make appropriate decisions, better self-manage the condition, and participate effectively in dialogue with caregivers [1].

The justification for this audit lies in the precept that well-informed patients are more apt to follow through with their treatment regimens and report adverse effects in a timely manner, hence enhancing overall outcomes. The National Institute for Health and Care Excellence (NICE) guideline CG137, "Epilepsies: diagnosis and management," emphasizes patient education, specifically calling for individuals beginning AED treatment to be counseled on the potential side effects of medications [2].

In order to assess current practice and pinpoint areas of possible shortfall, this audit aims to determine whether patients prescribed new AEDs are being suitably informed regarding side effects in terms of the NICE guidelines. Through the comparison of current practice with standards in guidelines, the audit aims to bring areas for improvement to the forefront and contribute to more effective patient education in clinical practice.

Inclusion Criteria

The patients who had newly been prescribed antiepileptic drugs (AEDs) for the control of epilepsy or seizure disorders were the focus of the audit. Only those were considered who were newly started on AED treatment within the prescribed audit period. This was so that the evaluation was directed toward the most relevant point where education of the patient is most crucial—at the starting point of the treatment.

Data Collection

Data were gathered by two main methods: a medical record review and patient surveys. The medical record review was designed to determine if there was documented evidence that patients were counselled about the possible side effects of the AEDs they were prescribed. This involved reviewing clinical notes, electronic health records, and discharge summaries for any reference to counselling about drug risks. Concurrently, questionnaires were given to the patients to measure their recall of the information given to them upon prescription. The questionnaire asked whether they had been made aware of side effects and whether they had found the information sufficient and clear.

Audit Standards

The audit criteria were based on the National Institute for Health and Care Excellence (NICE) guideline CG137 that informed patients ought to be offered detailed information concerning their treatment and AEDs' possible side effects. Hence, the benchmark established for the audit was 100% in regard to the documentation of patient education in clinical records and patient recall of having been informed. This benchmark was selected to represent best practice and to highlight the need for patient understanding in the effective and safe use of AEDs.

The initial cycle of audit identified major gaps in documentation of patient education and patient recall of antiepileptic drug (AED) side effects. Documentation of education was inconsistent across age groups, and patient understanding and satisfaction were also highly variable.

Table 1: Documentation and Recall of AED Side Effect Education by Age Group (First Cycle)

Documentation was highest in the 56+ age group (70%) and lowest in the 36–45 age group (50%). The overall average documentation rate was 60%, which was below the NICE target of 100%. Patient recall also differed, with complete recall between 20% and 35%, and partial recall being highest in the youngest age group (18–25) at 50%. In particular, 50% of patients in the group aged 36–45 responded that they recalled no side effect education. Scores for satisfaction echoed these patterns with the lowest level of satisfaction registered in the group aged 36–45 (5.5) and highest in those older than 56 (7.0).

After implementing organized educational protocols, staff training, and adjunct materials, a second cycle was administered to assess the effect of these interventions.

Table 2: Documentation and Recall of AED Side Effect Education by Age Group (Second Cycle)

The second cycle indicated a significant improvement in all indicators. Rates of documentation increased significantly, to 90% in the 56+ group and to 70% even in the formerly lowest-performing group (36–45). Complete recall increased in all age groups, and the percentage of patients unable to recall any education plummeted. Satisfaction scores increased proportionally, averaging above 8.0 in all but one group.

To measure the external factors that affect learning outcomes, lifestyle habits were considered as a potential contributor.

Table 3: Impact of Lifestyle Factors on Education Effectiveness

Active, healthier patients showed greater documentation and recall rates, along with improved clinical outcomes, such as reduced readmission and decreased hospital stays. This indicates a potential relationship between health engagement and educational effectiveness.

In addition, the process by which education was delivered was discovered to affect patient outcomes.

Table 4: Effectiveness of Education Delivery Method

Face-to-face interviews were the optimal delivery mode with the highest levels of documentation and recall and the highest satisfaction rates. Electronic material was also of use, though less so. Group sessions yielded the lowest of these measures.

Lastly, the recall of certain side effect categories was evaluated to assess the extent of patient awareness and behavior.

Table 5: Correlation between Education Effectiveness and Specific Side Effects Awareness

Patients exhibited maximum awareness of the cognitive side effects, with reciprocal increases in the reporting and, in turn, medication adjustments. This indicates a very strong correlation among targeted education, patient empowerment in the management of their treatment.

In general, these findings support the value of organized, patient-focused educational methods in enhancing knowledge, satisfaction, and outcomes for AED therapy.

The first cycle of the audit reveals a notable gap in both documentation and patient recall regarding education on AED side effects. The data shows that only 60% of patient education was documented, with just 20% of patients fully recalling the information provided. This indicates a potential area for improvement in both how information is conveyed to patients and how its provision is recorded. The disparity between documented education and patient recall suggests that the education method may not be sufficiently engaging or comprehensive, or that follow-up on the education provided is necessary to reinforce understanding.

The second cycle of the audit, conducted after implementing a multi-step action plan, demonstrates significant improvements. Documentation of patient education increased to 80%, and patient recall improved to 40%. These results suggest that the new protocols, staff training, and enhanced educational materials positively impacted the effectiveness of patient education. However, despite these improvements, there is still room for growth to achieve the 100% documentation and recall rates as per NICE guidelines [3].

In analyzing the impact of lifestyle factors and education delivery methods, the data highlights several key insights. Patients with an active and healthy lifestyle had higher documentation and recall rates, lower readmission rates, and shorter lengths of stay compared to those with sedentary and unhealthy lifestyles. This underscores the importance of considering lifestyle factors when designing and implementing patient education strategies. Additionally, in-person consultations were found to be the most effective delivery method, with the highest rates of documentation, recall, and patient satisfaction. Digital materials and group sessions, while beneficial, were less effective compared to in-person consultations, suggesting that personalized, face-to-face interactions may be crucial for effective patient education [4].

The audit also explored the correlation between education effectiveness and specific side effects awareness. Patients were more likely to recall information about cognitive impacts, physical discomfort, and mood alterations when education was thorough and engaging. However, the recall rates for these specific side effects varied, indicating that tailored educational approaches might be necessary to address different aspects of AED side effects comprehensively. The findings suggest that improved patient education on specific side effects can lead to better patient empowerment, enabling patients to manage their treatment more effectively and potentially reduce the need for medication changes due to unanticipated side effects.

The overall improvement in satisfaction scores from an average of 6.5 in the first cycle to 8.2 in the second cycle indicates that patients found the enhanced educational materials and methods more satisfactory. This increase in satisfaction is likely linked to the improved recall and understanding of AED side effects, which in turn can lead to better adherence to treatment and overall patient outcomes [5].

As a result of the findings of this audit, some specific enhancements are proposed to enhance the effectiveness of patient education on side effects of antiepileptic drugs (AEDs). One such area for improvement is educational material quality and dissemination. Patients would probably gain more from information that is effective in terms of its interaction, visual informatics, and accessibility. Including visual aids, interactive material, or electronic mediums like mobile applications or online modules could have a large impact on understanding and recall, particularly in younger patients who are more adept at using digital tools [6].

Just as critical, however, is the necessity of standardizing document processes in clinic environments. Establishing a single checklist or framework protocol can have the effect of ensuring that practitioners always document when and how they provide patient education. This not only would make compliance with such national guidelines as NICE CG137 more accurate but also create a reference from which future consultants could benefit in terms of checking the information conveyed over time to other team members.

Along with foundational education, there needs to be organized follow-up to reinforce patient comprehension. Planning for specific follow-up visits or calls to revisit educational material can greatly enhance patient recall and interest. These check-ins provide the opportunity for patients to ask questions, clear up confusion, and discuss any side effects they encountered, thus enabling improved communication among patients and health care providers. Together, these enhancements are anticipated to result in more educated patients, improved compliance with treatment, and subsequently, enhanced clinical outcomes.

In conclusion, the initial audit cycle highlighted critical areas for improvement in patient education regarding AED side effects. Addressing these gaps through targeted interventions, such as standardized protocols, staff training, and the development of patient-friendly materials, has significantly enhanced patient outcomes, adherence to medication, and overall quality of life for individuals with epilepsy. The planned re-audit confirms the effectiveness of these interventions, demonstrating higher compliance with NICE guidelines and ensuring that all patients receive and recall necessary education about their treatment. Moving forward, ongoing reviews of educational materials and continuous education for healthcare providers will be essential to maintain and further improve these outcomes.

1. (2021). "Epilepsies: diagnosis and management." NICE guideline [NG217]. https://www.nice.org.uk/guidance/ng217
2. American Epilepsy Society. (2016). "Guidelines for the treatment of epilepsy." https://www.aesnet.org/clinical_resources/guidelines
3. World Health Organization. (2019). "Epilepsy: a public health imperative." https://www.who.int/publications/i/item/epilepsy-a-public-health-imperative
4. Epilepsy Foundation. "Medication Safety and Side Effects." https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-medication-list/medication-safety-and-side-effects
5. Devinsky, O., et al. "Patient education improves seizure control and quality of life in people with epilepsy." Epilepsy & Behavior, 19(3), 158-162.
6. Schachter, S. C. "The impact of patient education on the quality of life in epilepsy." Epilepsy & Behavior, 13(4), 529-534.