Abstract Details

Title Improving Medication Non-Adherence Screening and Provider Interventions for Children with Epilepsy

Topic Child Neurology and Developmental Neurology

Presentation(s) Child Neurology and Developmental Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 085

Objective The objectives of this ongoing quality improvement project are to increase patient/family screening and provider counseling regarding anti-seizure medication non-adherence for pediatric patients with epilepsy.

Background Medication non-adherence in children with epilepsy is a substantial healthcare concern as adherence is one of the only modifiable risk factors of SUDEP. Substantial variability exists among providers regarding definitions of and screening approaches for medication non-adherence.

Design/Methods This is a quality improvement project at the Children’s Hospital of Philadelphia. We modified and implemented a medication adherence barrier screening questionnaire developed by the Epilepsy Learning Healthcare System (ELHS). Ongoing improvement cycles have focused on increasing the rate of questionnaire completion and interventions and counseling provided by clinicians.

Results Our baseline data prior to our standardized screening tool indicates that of the visits that addressed adherence, only 4% noted non-adherence. We have administered 353 screening questionnaires to our patients and families. Overall screening response rate has been 43%. Among those who completed the questionnaire, 52% of patients/caregivers endorsed either barriers to adherence (which may or may not lead to missed dosages) or non-adherence in some form. Clinician counseling or intervention was documented for 46% of the patients who reported non-adherence.

Conclusions Medication non-adherence issues were identified in only 4% of baseline visits and 52% of visits after implementation of a standardized screening questionnaire. We believe, a standardized screening questionnaire may allow for better recognition of medication-taking barriers, providing clinicians with increased opportunities to improve adherence. To improve questionnaire response rates, we will implement in-office questionnaires. To improve provider intervention rates, we will implement the ELHS Medication Adherence Barriers Toolkit to expand the resources clinicians can use to address medication-taking barriers for their patients. These efforts will be key to improving medication adherence, physician-patient communication, and health outcomes for patients with epilepsy.

Authors/Disclosures
Jaclyn Tencer, MD PRESENTER	Dr. Tencer has nothing to disclose.
Nicholas S. Abend, MD, F�鶹��ýӳ�� (Children's Hospital of Philadelphia)	Dr. Abend has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Epilepsy Foundation. The institution of Dr. Abend has received research support from NIH. The institution of Dr. Abend has received research support from PCORI. Dr. Abend has received publishing royalties from a publication relating to health care.
Marissa P. DiGiovine, MD	The institution of Dr. DiGiovine has received research support from HRSA.
Mark P. Fitzgerald, MD, PhD (Children's Hospital of Philadelphia)	Dr. Fitzgerald has nothing to disclose.
Lawrence E. Fried, MD (Children's Hospital of Philadelphia, Child Neurology)	Dr. Fried has received personal compensation for serving as an employee of Bayer Pharmaceuticals. Dr. Fried has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Virpax Pharmaceuticals. Dr. Fried has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Fried has stock in Bayer. Dr. Fried has stock in Horus. The institution of Dr. Fried has received research support from Health Resources & Services Administration of the United States Department of Health and Human Services.
	No disclosure on file
Ingo Helbig, MD (Children's Hospital of Philadelphia)	The institution of Dr. Helbig has received research support from NIH, German Research Foundation, The Hartwell Foundation, International League Against Epilepsy. Dr. Helbig has received intellectual property interests from a discovery or technology relating to health care.
Marisa S. Prelack, MD (Children's Hospital of Philadelphia, Neurology)	Dr. Prelack has nothing to disclose.
Uzma Sharif, MD	Dr. Sharif has nothing to disclose.
Sara Molisani, MD (Children's Hospital Of Philadelphia)	Dr. Fridinger has nothing to disclose.

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