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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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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