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dc.contributor.authorShankar, Rohit
dc.contributor.authorGoodwin, Melesina
dc.contributor.authorToland, John
dc.contributor.authorBoyle, Andrew
dc.contributor.authorGrant, Amanda
dc.contributor.authorPearson, Josephine
dc.contributor.authorStorer, Amanda
dc.contributor.authorHiggins, Richard
dc.contributor.authorHudson, Sharon
dc.contributor.authorReuber, Markus
dc.date.accessioned2021-09-15T08:59:39Z
dc.date.available2021-09-15T08:59:39Z
dc.date.issued2021-08-07
dc.identifier.citationShankar, R, Goodwin, M., Toland, J., Boyle, A., Grant, A., Pearson, J.,Storer, A., Higgins, R., Hudson, S., and Reuber, M. (2021). 'Oro-mucosal midazolam maleate: Use and effectiveness in adults with epilepsy in the UK'. Epilepsy Behavior, Volume 123, pp. 1-4.en_US
dc.identifier.issn15255050
dc.identifier.urihttp://hdl.handle.net/10545/625998
dc.description.abstractOro-mucosal midazolam maleate (OMM) with suitable training to family and carers is being increasingly recognized as the treatment of choice to mitigate the development of status epilepticus in non-hospital community settings. There are no studies to describe the use, effectiveness, and suitable dosing of OMM in adults with epilepsy in community settings. To describe the use, effectiveness, and dosing of OMM in the emergency treatment of epileptic seizures in community settings. A retrospective observational study (2016–17) design was used with participant recruitment from four UK NHS secondary care outpatient clinics providing epilepsy management. Study sample was of adult people with epilepsy (PWE) having had a recent seizure requiring OMM. Data on patient demographics, patient care plans, details of a recent seizure requiring emergency medication, and dose of OMM were collected from medical records. Study data from 146 PWE were included. The mean age of PWE was 41.0 years (SD 15.2) and mean weight was 64.8Kg (SD 18.2). Fifty-three percent of PWE were recorded as having intellectual disability. The most frequently used concomitant medications were lamotrigine (43%). The majority of seizures occurred at people’s homes (n = 92, 63%). OMM was most often administered by family/professional care-givers (n = 75, 48.4%). Generalized (tonic/clonic) seizures were recorded in most people (n = 106, 72.6%). The most common initial dose of OMM was 10 mg (n = 124, 84.9%). The mean time to seizure cessation after administration of this initial dose was 5.5 minutes (SD = 4.5, Median 5.0, IQR 2.1–5.0). Only a minority of seizures led to ambulance callouts (n = 18, 12.3%) or hospital admissions (n = 13, 9%). This is the first observational study describing the use and effectiveness of OMM in adults in community settings. Minimal hospital admissions were reported in this cohort and the treatment was effective in ending seizures in adults in community settings.en_US
dc.description.sponsorshipTim Futter, Joseph hickey and Kavitha Baruah - Open Vie Limited (formerly pH Associates)en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.urlhttps://www.sciencedirect.com/science/article/pii/S1525505021005035#!en_US
dc.relation.urlhttps://eprints.whiterose.ac.uk/177073/
dc.rights© 2021 Elsevier Inc. All rights reserved.
dc.subjectBuccal midazolamen_US
dc.subjectRescue medicationen_US
dc.subjectCommunity prevention of statusen_US
dc.subjectEpilepsy safetyen_US
dc.subjectIntellectual disabilitiesen_US
dc.titleOro-mucosal midazolam maleate: Use and effectiveness in adults with epilepsy in the UKen_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.contributor.departmentUniversity of Plymouth Medical Schoolen_US
dc.contributor.departmentCornwall Partnership, NHS Foundation Trusten_US
dc.contributor.departmentNorthampton General Hospital, NHS Trusten_US
dc.contributor.departmentNHS Fifeen_US
dc.contributor.departmentNHS Lothianen_US
dc.contributor.departmentUniversity of Derbyen_US
dc.contributor.departmentSheffield Teaching Hospitals, NHS Foundation Trusten_US
dc.contributor.departmentUniversity of Sheffielden_US
dc.identifier.journalEpilepsy & Behavioren_US
dc.identifier.eid1-s2.0-S1525505021005035
dc.identifier.piiS1525-5050(21)00503-5
dc.source.journaltitleEpilepsy & Behavior
dc.source.volume123
dc.source.beginpage108242
dcterms.dateAccepted2021-07-24
dc.author.detail785669en_US


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