The Development And Application Of Database Software Of Epilepsy Patients

PART 1 THE DEVELOPMENT AND APPLICATION OF DATABASE SOFTWARE OF EPILEPSY PATIENTSObjective Developing the large database software of single epilepsy in Gansu Province,using the function of the database software to classify and manage the clinical information of patients.According to different research purposes,study the retention rate of antiepileptic drugs,drug response model and epidemiological characteristics of epilepsy diseases in clinical need of large data and long-term research to answer this questions,which is more scientifically,reasonably and efficiently manages patients.Methods According to the characteristics of epilepsy and the current epidemiological and medical conditions of epilepsy in Gansu Province,the clinical information of epilepsy patients is classified modularily by using international standard fields,and the basic framework of database software was structured.Based on Windows Server 2012 operating system,the professional software engineer develops it by using Microsoft Visual Studio 2017.The database management software was designed and developed.Results A large database software for single epilepsy disease was built,which integrates data input,storage,statistical analysis,management,extraction and sharing.The relationship between each module is in line with the actual clinical situation.All functions can be accessed smoothly and the user's access needs can be completed in a short time.The informationalized and standardized management of clinical data have been completed to realize the long-term clinical data.Periodic storage and regular updates,the current database is running well.Conclusions The database software is a relatively advanced single disease management software in China.It can be connected with Aliyun and mobile APP,andcan quickly complete data collection.It can not only help clinicians better manage patients,but also provide the most authentic and reliable original clinical data for clinical scientific research.PART 2 STUDY ON DRUG RETENTION RATES AND ITS INFLUENCING FACTORS OF LEVETIRACETAM MONOTHERAPY IN NEWLY DIAGNOSED EPILEPSY PATIENTSObjective To study the drug retention rates of levetiracetam monotherapy for newly diagnosed epilepsy patients,analyze the drug retention rates of LEV in one year in patients with different educational level,regions,seizure forms,etiology,dosage of drugs,age of onset and different course of disease,understand the reasons of cumulative drug withdrawal,and analyze the risk factors affecting the cumulative drug withdrawal rate of LEV in 6 months and one year.Methods Based on the preliminary database software,230 newly diagnosed epilepsy patients treated with LEV monotherapy from October 2016 to February 2018 were selected and included in the established database.A drug retention rates follow-up study sub-module was established to follow up epilepsy patients with different educational level,regions,seizure forms,etiology,dosage of drugs,age of onset and different course of disease in 3 months,6 months,9 months and one year drug retention rates,analysis of different factors in one year drug retention rates of LEV,explore the reasons for the cumulative withdrawal,and analyze the correlation between the factors of withdrawal and the cumulative withdrawal of patients for 6months and one year.Results1 A total of 230 patients were enrolled,110 males(47.8%)and 120 females(52.2%).The age of males was 23.5±2.7 years old and that of females was 19.5±3.5years old.There was no significant differences in age composition between males and females(P > 0.05).2 The overall retention rates of drugs in 3 months,6 months,9 months and one year after administration were 95.7%,88.3%,81.7% and 70.4%.The retention rates decreased with time,and there was statistical differences between them(chi-square test: ?2value was 58.772,P < 0.05).3 The one year retention rates of LEV for different factors: There was no significant differences between degree of Education(chi-square test: ?2 value was8.833,P > 0.05);in different areas,rural 69.6%,urban 84.7%,urban higher than rural areas,and there was statistical differences between them(chi-square test: ?2 value was5.170,P < 0.05);The types of seizures with the same epilepsy were focal origin82.9%,comprehensive origin 63.3% and unknown origin 50.0%.There was statistical differences between them(chi-square test: ?2 value was 18.217,P < 0.05);the retention rates of structural and unknown etiology were the best,which had statistical differences with other etiologies(P < 0.05);the retention rates of daily dose 20~40(mg/kg)was the best,which had statistical difference with other dosages(P < 0.05);the longer the course of disease,the lower the retention rates,the best retention rates was less than one year,and there was statistical differences with other courses(P <0.05);the younger the age of onset,the higher the retention rates,the best retention rates was patients of younger than 18 years old,and there was statistical differences with other age of onset(P < 0.05).4 Factors in patients with cumulative withdrawal:The main factors affecting the cumulative drug withdrawal rate were lack of efficacy,adverse reactions,drug prices,objective factors and subjective factors.Multivariate logistic regression analysis showed that the main factors affecting the cumulative drug withdrawal rate of LEV in6 months were lack of efficacy,objective factors and subjective factors(OR=3.087,5.071,2.638,all P < 0.05);the main factors affecting the cumulative drug withdrawal rate of LEV in one year were drug price and objective factors(OR=6.431,2.956,all P< 0.05).Conclusions There were many factors affecting drug retention rates,such as patients with regions,seizure forms,etiology,dosage of drugs,age of onset and course of disease.In urban areas,structural and unknown etiology,daily dosage of20~40(mg/kg),course of disease less than one year,and the age of onset less than18 years,the LEV one year drug retention rates was the best.The main factors affecting the cumulative drug withdrawal rate were different in different periods.Actively controlling the main factors in each period can improve the overall retention rate of LEV.