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Abstract Details

Reducing seizure burden significantly improves patient reported outcomes and decreases health resource utilization amongst patients with convulsive seizures.
Epilepsy/Clinical Neurophysiology (EEG)
P15 - Poster Session 15 (12:00 PM-1:00 PM)
12-005

We aim to study the relationship between active generalized tonic-clonic seizures (GTCs), patient-reported outcomes (PROs) and healthcare resource utilization (HCRU).

We have reported poorer baseline PROs and greater HCRU among patients with active GTCs (i.e. > 0 convulsive seizures in the last 6 months). The extent to which reducing seizure burden is correlated with PROs and HCRU remains unclear.

We prospectively collected survey data from 379 patients (192 GTC+, 187 GTC-) diagnosed with drug-resistant epilepsy being treated in a comprehensive epilepsy center (2012-2017) for at least 1 year. We compared seizure frequency and severity (Liverpool Seizure Severity Scale LSSS), work and driving status, quality of life (Quality of Life in Epilepsy Questionnaire, QOLIE-10), depressive symptoms (Patient Health Questionnaire PHQ9), anxiety (Generalized Anxiety Disorder 7-item, GAD-7), and HCRU (including frequency of emergency department visits and hospitalizations) at baseline and 1 year. 

One year after their initial visit, GTC+ patients reported lower seizure frequency (mean 0.1 vs 0.3 seizures/day, p<0.001), lower seizure severity (mean LSSS 24.0 vs 36.4, p=0.005), better overall quality of life (mean QOLIE-10 24.3 vs 29.7, p<0.001) and better depression scores (mean PHQ9 7.5 vs 10.2, p<0.001). Patients also reported reduced emergency department (ED) visits in the last 3 months (18% reported a recent ED visits at 1 year, compared to 40% at baseline, p=0.005), and a trend towards lower hospitalization rate (8% reported a recent hospitalization at 1 year, compared to 17% at baseline, p=0.057). Analysis of variance revealed a significant association between change in seizure frequency and change in LSSS (p<0.001), QOLIE-10 (p<0.001), PHQ-9 (<0.001), and GAD-7 (p=0.003) but not for ED visits (p=0.382) or hospitalizations (p=0.773).
Reducing seizures was associated with improvement in patient reported quality of life amongst GTC+ patients and temporally correlated with decreased utilization of high-cost care.
Authors/Disclosures
Shehryar Sheikh
PRESENTER 		No disclosure on file
Nicholas Thompson The institution of Nicholas Thompson has received research support from EMD Serono.
Feride H. Frech, PhD (Eisai Inc) Dr. Frech has received personal compensation for serving as an employee of Eisai Inc.
Manoj Malhotra, MD Dr. Malhotra has received personal compensation for serving as an employee of Eisai.
Lara Jehi, MD (Cleveland Clinic Epilepsy Center) Dr. Jehi has nothing to disclose.