Acceptance of the Use of Diazepam Rectal Gel in School and Day Care Settings

Abstract

This study was conducted to identify how often parents of children with epilepsy encounter barriers to the use of diazepam rectal gel in day care or school settings and how these barriers affect the child and family. Sixty-four parents completed an 18-item questionnaire documenting their experience with asking their child's school to administer diazepam rectal gel. No data regarding its actual use in the school was obtained. Forty-three parents (68%) had asked their school to administer diazepam rectal gel; 35 (81%) reported school agreement, and 8 (19%) reported refusal. In 5 of these refusals, the cited reason was legal concerns, and in 5 cases the refusal had some adverse effect on their family's life. Most children prescribed diazepam rectal gel do not encounter resistance to its use in school and day care settings. Barriers to its use are usually due to legal concerns and significantly affect the family's quality of life.

Keywords

rectal diazepam schools barriers

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References

Alldredge BK , Wall DB , Ferriera, DM Effect of prehospital treatment on the outcome of status epilepticus in children. Pediatr Neurol. 1995;12:213-216.

O'Dell C. , Shinnar S. , Ballaban-Gil KR , et al. Rectal diazepam gel in the home management of seizures in children . Pediatr Neurol. 2005;33:166-172.

Camfield CS , Camfield PR , Smith E. , Dooley JM Home use of rectal diazepam to prevent status epilepticus in children with convulsive disorders. J Child Neurol. 1989 ;4:125-126.

Cereghino JJ , Mitchell WG , Murphy J. , Kriel RL , Rosenfeld WE , Trevathan E. The North American Diastat Study Group: treating repetitive seizures with a rectal diazepam formulation. Neurology . 1998;5:1274-1282.

Kriel RL , Cloyd JC , Hadsall RS , Carlson AM , Floren KL , Jones-Saete CM Home use of rectal diazepam for cluster and prolonged seizures: efficacy, adverse reactions, quality of life, and cost analysis. Pediatr Neurol. 1991;7:13-7.

Mitchell WG , Conry JA , Crumrine PK , et al. North American Diastat Group: An open-label study of repeated use of diazepam rectal gel (Diastat) for episodes of acute breakthrough seizures and clusters: safety, efficacy, and tolerance. Epilepsia. 1999;40: 1610-1617.

Cloyd JC , Lalonde RL , Beniak TE , Novack, GD : A single-blind, crossover comparison of the pharmacokinetics and cognitive effects of a new diazepam rectal gel with intravenous diazepam. Epilepsia. 1998;39:520-526.

Epilepsy Legal Defense Fund, Epilepsy Foundation. Diastat Administration in Schools: Summary of Relevant Federal Laws and Selected Cases. 2006. Available at: http://www.epilepsyfoundation .org/epilepsylegal/genattyresources.cfm. Accessed November 12, 2006.

Ohio Revised Code 3313.713. Available at: http://codes.ohio .gov/orc/3313.713. Accessed July 11, 2007.

10.

Ohio Administrative Code Ann 4723-13-04(A)(2) and 4723.32(D). Available at: http://codes.ohio.gov/oac/4723-13 and http://codes .ohio.gov/orc/4723.32. Accessed July 11, 2007.

11.

American Academy of Pediatrics (AAP) Committee on School Health. Guidelines for the administration of medication in school. Pediatrics. 2003;112:697-699.

12.

Epilepsy Foundation. Use of New Treatments in Schools, Child Care and Camps. 2006. Available at: http://www.epilepsyfoundation.org/advocacy/care/treatments.cfm . Accessed November 12, 2006.

13.

Ohio Administrative Code 5123:2-6-05. Available at: http:// codes.ohio.gov/oac/5123:2-6-05. Accessed July 11, 2007.