Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren

Abstract Background Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepilepti...

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Main Authors: Michael Fleming, Catherine A. Fitton, Markus F. C. Steiner, James S. McLay, David Clark, Albert King, Daniel F. Mackay, Jill P. Pell
Format: Article
Language:English
Published: BMC 2019-05-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-019-6888-9
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spelling doaj-be83fb6fc0a14bbaafe0bdfacef958732020-11-25T03:16:33ZengBMCBMC Public Health1471-24582019-05-0119111210.1186/s12889-019-6888-9Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildrenMichael Fleming0Catherine A. Fitton1Markus F. C. Steiner2James S. McLay3David Clark4Albert King5Daniel F. Mackay6Jill P. Pell7Institute of Health and Wellbeing, University of GlasgowDepartment of Child Health, University of AberdeenDepartment of Child Health, University of AberdeenDepartment of Child Health, University of AberdeenInformation Services DivisionScotXed, Scottish GovernmentInstitute of Health and Wellbeing, University of GlasgowInstitute of Health and Wellbeing, University of GlasgowAbstract Background Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. Methods Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. Results Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. Conclusions Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.http://link.springer.com/article/10.1186/s12889-019-6888-9EpilepsyEducational outcomesHealthPopulation cohortRecord linkagePrescribing
collection DOAJ
language English
format Article
sources DOAJ
author Michael Fleming
Catherine A. Fitton
Markus F. C. Steiner
James S. McLay
David Clark
Albert King
Daniel F. Mackay
Jill P. Pell
spellingShingle Michael Fleming
Catherine A. Fitton
Markus F. C. Steiner
James S. McLay
David Clark
Albert King
Daniel F. Mackay
Jill P. Pell
Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
BMC Public Health
Epilepsy
Educational outcomes
Health
Population cohort
Record linkage
Prescribing
author_facet Michael Fleming
Catherine A. Fitton
Markus F. C. Steiner
James S. McLay
David Clark
Albert King
Daniel F. Mackay
Jill P. Pell
author_sort Michael Fleming
title Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
title_short Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
title_full Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
title_fullStr Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
title_full_unstemmed Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren
title_sort educational and health outcomes of children and adolescents receiving antiepileptic medication: scotland-wide record linkage study of 766 244 schoolchildren
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2019-05-01
description Abstract Background Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. Methods Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. Results Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. Conclusions Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.
topic Epilepsy
Educational outcomes
Health
Population cohort
Record linkage
Prescribing
url http://link.springer.com/article/10.1186/s12889-019-6888-9
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