Leone Lorna Ridsdale

Leone Lorna Ridsdale
King's College London | KCL · Department of Clinical Neuroscience

MA MSc MD PhD FRCPC FRCGP

About

202
Publications
20,253
Reads
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3,889
Citations
Introduction
Neuro-epidemiolgy; neurology services in general practice; trials of novel neurology services in the community, particularly for common long-term conditions like headache, fatigue and epilepsy.
Additional affiliations
October 2000 - present
Guy's and St Thomas' NHS Foundation Trust
Position
  • Honorary Consultant
January 1999 - June 2016
King's College London
Position
  • Professor (Full)
October 1985 - present
King College
Position
  • Professor (Full)
Education
September 2006 - June 2008
University of Sussex
Field of study
  • Creative writing
September 1991 - July 1994
King's College London
Field of study
  • Medicine
August 1971 - July 1974
McMaster University
Field of study
  • Medicine

Publications

Publications (202)
Article
Full-text available
Introduction Anecdotal reports suggest that clopidogrel may prevent migraine attacks. We undertook a pilot randomised trial. Method We randomised consecutive migraineurs with 4-15 attacks per 28 day month to receive clopidogrel 75 mg or placebo daily for 3 months. Headache was primarily assessed with a headache diary. Results There were no statist...
Article
Full-text available
Objectives People with epilepsy (PWE) have a higher mortality rate than the general population. Epilepsy-related deaths have increased despite all-cause mortality decreasing in the general population pre-COVID-19. We hypothesised that clinical and lifestyle factors may identify people more at risk. Design We used a retrospective cohort study to ex...
Article
There are two peaks of diagnosis of epilepsy: in childhood and in people over 65. Older people may have complex needs like co-morbidity, polypharmacy, frailty, and social isolation. This scoping review focusses on the care of older people with epilepsy beyond diagnosis and medical treatment. We sought to identify areas within the UK health service...
Article
Background No seizure first aid training intervention exists for people with epilepsy who regularly attend emergency departments and their significant others, despite such an intervention’s potential to reduce clinically unnecessary and costly visits. Objectives The objectives were to (1) develop Seizure first Aid training For Epilepsy (SAFE) by ad...
Article
Full-text available
Background: No seizure first-aid training intervention exists for people with established epilepsy (PWE) who regularly attend emergency departments (ED) and their significant others (SO), despite the potential to reduce clinically unnecessary and costly visits. Objectives: (1) Develop Seizure First Aid Training For Epilepsy (SAFE) by adapting a b...
Article
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Purpose: Emergency Department (ED) visits are costly to the health service and alternative care pathways may address this whilst improving outcomes. We aimed to describe decision-making and preferences of people with epilepsy (PWE) during emergency service use, and views of ED alternatives, including use of an Urgent Treatment Centre and telephone-...
Article
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Objective: To determine the feasibility and optimal design of a randomised controlled trial (RCT) of Seizure First Aid Training For Epilepsy (SAFE). Design: Pilot RCT with embedded microcosting. Setting: Three English hospital emergency departments (EDs). Participants: Patients aged ≥16 with established epilepsy reporting ≥2 ED visits in the prior...
Article
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PURPOSE: Epilepsy is associated with costly unplanned health service use. The UK’s National Audits of Seizure Management in Hospital found use was often clinically unnecessary, avoidable and typically led to little benefit for epilepsy management. We systematically identified how services have responded to reduce such use. METHODS: We invited Eng...
Article
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Introduction: Emergency department (ED) visits for epilepsy are common, costly, often clinically unnecessary and typically lead to little benefit for epilepsy management. An 'Alternative Care Pathway' (ACP) for epilepsy, which diverts people with epilepsy (PWE) away from ED when '999' is called and leads to care elsewhere, might generate savings a...
Article
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Objective We aimed to describe patients’ views of a new referral pathway of general practitioner (GP) direct access to MRI, versus imaging after referral to a specialist. Design This qualitative study involved 20 semistructured interviews. Twenty patients (10 from each pathway) were purposively recruited and interviewed to describe their attitudes...
Article
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Background: To help with a long-term but invisible medical condition such as migraine, many people seek information and support on social media. The effect of using social media for people with migraine is not fully understood and remains to be investigated. Objective: The aim of this study was to describe how people with migraine use social med...
Article
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Purpose: To measure fidelity with which a group seizure first aid training intervention was delivered within a pilot randomized controlled trial underway in the UK for adults with epilepsy who visit emergency departments (ED) and informal carers. Estimates of its effects, including on ED use, will be produced by the trial. Whilst hardly ever repor...
Article
Background: Web-based media, particularly social networking sites (SNSs), are a source of support for people with long-term conditions, like epilepsy. Living with epilepsy can reduce opportunities for accessing information and social support owing to transportation difficulties and stigma leading to self-isolation. However, some people with epileps...
Conference Paper
Full-text available
Background: There is little evidence on how people with epilepsy (PWE) use web-based media in self-management of their condition. This study focused on the benefits/risks for PWE using social networking sites and web-based media. Methods: We recruited 14 PWE who had volunteered after seeing information provided by Epilepsy Action, UK. We asked ope...
Conference Paper
Full-text available
Introduction: ‘Invisible’ conditions like migraine may leave individuals seeking support and information. We aimed to describe how people with migraines use and benefit from social media and to identify harms of social media use. Methods: Twenty participants were recruited via migraine charities. Semi-structured interviews were conducted with ques...
Conference Paper
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Introduction: When General Practitioners (GPs) refer patients with headache to neurologists, it is often because the patient and/or doctor want imaging. Some GPs now access Magnetic Resonance Imaging (MRI) directly. We aimed to describe patients’ experience of GPs using direct access, compared to patients who saw a specialist first. Methods: We in...
Article
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Objective: To investigate the responsiveness of and correlation between the EQ-5D-5L and the QOLIE-31P in patients with epilepsy, and develop a mapping function to predict EQ-5D-5L values based on the QOLIE-31P for use in economic evaluations. Methods: The dataset was derived from two clinical trials, the ZMILE study in the Netherlands and the S...
Article
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Background Epilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting. Objectives To determine the effecti...
Article
Full-text available
Objective Epilepsy is one of the most common neurological conditions affecting about 1% of adults. Up to 40% of people with epilepsy (PWE) report recurring seizures while on medication. And optimal functioning requires good self‐management. Our objective was to evaluate a group self‐management education courses for people with epilepsy and drug‐res...
Article
Full-text available
Attendance at UK Emergency Departments (EDs) for People with epilepsy (PWE) following seizure can be unnecessary and costly. The characteristics of PWE attending a UK rural district ED in a 12 month period was examined to foster better understanding of relevant psycho-social factors associated with ED use by conducting cross sectional interviews us...
Article
Full-text available
Most epilepsy-related emergency department visits are by persons with established epilepsy who have experienced an uncomplicated seizure. Those frequently attending and their informal carers may benefit from a self-management intervention that improves seizure management confidence. We used a collaborative approach to develop such an intervention....
Article
Introduction People with epilepsy (PWE) want to learn about self-management. No course tested in UK. Methods Mixed-methods RCT evaluating group 2 day self-management education for poorly controlled epilepsy. Participants’ characteristics described at baseline, a sub-sample purposefully interviewed at 6 months, outcomes analysed at 1 year. Outcomes...
Article
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Objective: To conduct a cost of illness study to estimate the economic impact of referring people with headache to specialists. Background: Headache is one of the commonest health conditions affecting individuals in society. Methods: Participants formed a convenience sample and were recruited from specialist headache clinics across London. Sel...
Article
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Objectives To develop a better understanding of general practitioners’ (GPs) views and experiences of the management of patients with headaches and use of direct-access MRI scans, and observe outcomes of an educational session offered by a GP with a special interest (GPwSI) to GPs. Design A qualitative study using semistructured interviews, analys...
Article
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Background Complex interventions such as self-management courses are difficult to evaluate due to the many interacting components. The way complex interventions are delivered can influence the effect they have for patients, and can impact the interpretation of outcomes of clinical trials. Implementation fidelity evaluates whether complex interventi...
Article
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Background Epilepsy is a serious and costly long-term condition that negatively affects quality of life, especially if seizures persist on medication. Studies show that people with epilepsy (PWE) want to learn more about the condition and some educational self-management courses have been trialled internationally. The objectives of this review were...
Article
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Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants’, what clinical and psycho-social characteristics are associated with QoL? We recruited 404 adults attend...
Conference Paper
Full-text available
Introduction People with epilepsy (PWE) want to learn about self-management. No course tested in UK. Methods Mixed-methods RCT evaluating group 2-day self-management education for poorly controlled epilepsy. Participants’ characteristics described at baseline, a sub-sample purposefully interviewed at 6-months, outcomes analysed at 1-year. Outcomes...
Article
Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However , most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably...
Article
Attendance at UK Emergency Departments (EDs) for people with epilepsy (PWE) following a seizure can be unnecessary and costly. The characteristics of PWE attending a UK rural district ED in a 12-month period were examined to foster better understanding of relevant psycho-social factors associated with ED use by conducting cross-sectional interviews...
Article
Full-text available
Background and purpose: Having epilepsy requires individuals to learn about self-management. So far, trials of self-management courses have not included in-depth qualitative evaluations of how the learning method influences participants' perceptions and behaviour. We aimed to interview participants who had attended a course, as part of a randomize...
Article
Full-text available
Migraine causes major health impairment and disability. Psychological interventions offer an addition to pharmacotherapy but they are not currently recommended by the National Institute of Clinical Excellence (NICE) or available in the National Health Service. We aimed to systematically review evidence on the efficacy of psychological interventions...
Article
Full-text available
Background We are doing a multicentre, randomised controlled trial evaluating the effectiveness and cost-effectiveness of a two-day Self-Management education course for epILEpsy (SMILE (UK)), which was developed in Germany (MOSES). Methods We recruited participants attending epilepsy clinics in SE England, reporting 2 or more seizures in the prior...
Conference Paper
Full-text available
Purpose: Group self-management education courses for people with epilepsy have been tested in some countries, but not in the UK. We are doing a multicentre, randomised controlled, single-blind trial, evaluating the effectiveness and cost-effectiveness of a two-day English language Self-Management education course for epILEpsy (SMILE) in the UK. Thi...
Conference Paper
Background Group self-management courses are usual in Type 1 diabetes. Epilepsy is commoner, and group courses (MOSES) are offered freely in Germany. We adapted MOSES for the NHS, and are trialing it for people with poorly controlled epilepsy. Learning is interactive, with feelings and self-esteem discussed, and facts like the commonness of epileps...
Conference Paper
Background: We are doing a multicentre, randomised controlled trial evaluating the effectiveness and cost-effectiveness of a two-day Self-Management education course for epILEpsy (SMILE (UK)), which was developed in Germany (MOSES). Methods: We recruited participants attending epilepsy clinics in SE England, reporting 2 or more seizures in the pr...
Article
Full-text available
Background: Migraine headache has a high prevalence and a severe impact on personal, social and work life, forming a significant burden on patients, service providers and society. There is some evidence of the effectiveness of behavioural interventions to supplement drug therapy but a recognised need to identify an effective minimal contact approa...
Article
Full-text available
Headache is being viewed more commonly in a biopsychosocial framework, which introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy and relaxation. No such treatments have been trialled in the UK. We conducted a randomised controlled pilot trial, comparing a brief guided self-help CBT and relax...
Article
Full-text available
Background: Epilepsy is a long-term condition that requires self-management, but currently, there is no well-evaluated epilepsy self-education or self-management intervention in the United Kingdom (UK). Aim: The aim of this study was to examine the views and experiences of the first participants of the Self-Management in epILEpsy UK (SMILE UK) p...
Conference Paper
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For full details of the Development groups visit: http://www.epsmon.co.uk/health-professionals
Article
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Introduction: People with chronic epilepsy (PWE) often make costly but clinically unnecessary emergency department (ED) visits. Offering them and their carers a self-management intervention that improves confidence and ability to manage seizures may lead to fewer visits. As no such intervention currently exists, we describe a project to develop an...
Article
Full-text available
There is a need to test the effectiveness of new educational interventions for people with poorly controlled epilepsy. The SMILE (self-management education for adults with poorly controlled epilepsy) trial evaluates a complex service intervention that involves a 2-day self-management course with the aim of improving quality of life and clinical out...
Article
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General practice is the place to start, and much can be done An estimated 1.16 per 1000 people with epilepsy die suddenly each year.1 In 2013 there were 680 deaths from epilepsy among people aged under 75 (973 deaths at all ages) in England and Wales.2 Sudden death in epilepsy peaks in young adults, particularly men, so a 20 year old with epilepsy...
Thesis
Full-text available
Background Population-based studies have consistently found a two to three fold increase in mortality rates in patients with epilepsy (PWE) compared with the general population. The cause of this increase remains uncertain but several risk factors have been identified including non-adherence to medication, treatment for depression and alcohol abuse...
Article
Full-text available
Introduction:- Headache is the commonest reason for neurology referrals, and the commonest neurological reason for patients attending Emergency Departments (EDs). An ethical approach to health care requires that patients be provided with informed choice about management. However researchers have not addressed patients’ concerns and choices in manag...
Article
Full-text available
Introduction: Doctors in primary care are responsible for diagnosing and managing patients with headache, but frequently lack confidence in doing so. We aimed to compare Family Practitioners’ (FPs) diagnosis of headaches to classification based on a symptom questionnaire, and to describe how classification links to other important clinical features...
Article
Full-text available
The National Institute of Clinical Excellence suggested black ethnic minorities with epilepsy have different cultural, communicative and health-care needs. However, little is known about these despite increasing migration of black African and Caribbean people to Europe. This study aims to explore perceptions and experiences of epilepsy among black...
Conference Paper
Full-text available
Background Some people with epilepsy (PWE) make frequent emergency department (ED) visits, with up 50% being admitted. No UK studies have examined interventions for them. We aimed to test whether an epilepsy nurse specialist (ENS) might reduce ED attendance. Methods 85 adults with epilepsy were recruited, 41 receiving treatment-as-usual (TAU), and...
Conference Paper
Full-text available
Migraine causes major health impairment and disability costing the UK over £2 billion annually. Psychological interventions offer an addition to pharmacotherapy, but are not currently available in the NHS. We aimed to systematically review evidence on the efficacy of psychological interventions for migraine in adults published since 1999, when the...
Conference Paper
Full-text available
Introduction Teaching adults with epilepsy to manage seizure triggers, implement strategies to take antiepileptic drugs, minimize risks during seizures, and tell others what to do during seizures may lead to better self-management. No teaching programme has been tested in the UK. Methods This is a multicentre, pragmatic, parallel group RCT to eval...
Article
Full-text available
Introduction Headache is the commonest reason for neurology referrals, and the commonest neurological reason for patients attending Emergency Departments (EDs). An ethical approach to health care requires that patients be provided with informed choice about management. However researchers have not addressed patients' concerns and choices in managin...
Article
Full-text available
Teaching people with epilepsy to identify and manage seizure triggers, implement strategies to remember to take antiepileptic drugs, implement precautions to minimize risks during seizures, tell others what to do during a seizure and learn what to do during recovery may lead to better self-management. No teaching programme exists for adults with ep...
Article
Full-text available
People with chronic epilepsy (PWE) often make costly, and clinically unnecessary emergency department (ED) visits. Some do it frequently. No studies have examined interventions to reduce them. An intervention delivered by an epilepsy nurse specialist (ENS) might reduce visits. The rationale is it may optimize patients' self-management skills and kn...
Article
Full-text available
Objective: The National Institute of Clinical Excellence suggested black ethnic minorities with epilepsy have different cultural, communicative and health-care needs. However, little is known about these despite increasing migration of black African and Caribbean people to Europe. This study aims to explore perceptions and experiences of epilepsy a...
Conference Paper
Introduction: Research has found that people with epilepsy want to know more about their disorder. Patients with poorly controlled epilepsy, who experience multiple seizures each year, particularly need greater understanding of their condition in order to manage more effectively. Educational interventions, designed specifically for people with long...
Article
Full-text available
Can an epilepsy nurse specialist-led self-management intervention reduce attendance at emergency departments and promote well-being for people with severe epilepsy? A non-randomised trial with a nested qualitative phase L Ridsdale,1* P McCrone,1 M Morgan,1 L Goldstein,1 P Seed2 and A Noble1 1Institute of Psychiatry, King's College London, London, U...