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Abstract Details

Care priorities of patients with drug-resistant epilepsy
Epilepsy/Clinical Neurophysiology (EEG)
S35 - Epilepsy/Clinical Neurophysiology (EEG): Clinical Epilepsy (1:48 PM-2:00 PM)
005
To determine patient priorities during clinic visits for drug-resistant epilepsy (DRE)
Patients with DRE have complex care needs due to disabling illness and common comorbidities. While seizure control may be the dominant goal for clinicians, escalating treatment may not be an individual patient’s top priority. Understanding patients’ health preferences is essential to optimizing clinical outcomes. In this study, we surveyed patients to better understand specific priorities for upcoming epilepsy clinic visits.  
We recruited patients with epilepsy from our University’s health research e-platform. Patients completed survey questions regarding demographics, diagnosis, seizure control, and prior antiseizure medication (ASM) treatment, as well as communication with their physician and confidence in relaying preferences during their clinic visit (modeled after the validated questionnaire, Perceived Efficacy in Patient-Physician Interactions-PEPPI).

Of 46 patients with epilepsy, 19 reported answers consistent with DRE (i.e. 2+ ASMs and ongoing seizures in the last year). Patients with DRE were 63% female, 89% white, and 78% were ages 35-64. Over half of patients with DRE had failed 3+ drugs. When asked their top priority for their upcoming epilepsy clinic visit, 21% of patients with DRE chose improving thinking/memory, 16% chose improving anxiety/depression and 16% chose decreasing ASM due to side-effects; 16% chose increasing ASM. Only 21% (4/19) chose increasing or adjusting ASM amongst their top two priorities. Regarding communication and efficacy, 74% of patients felt very confident explaining their chief health concern to their provider.

We found a range of top priorities for clinic visits for patients with DRE. Notably, most patients with DRE did not consider ASM escalation to be amongst their top priorities. While most surveyed felt confident in relaying top concerns, tools to elicit and communicate care priorities beyond seizure control could enhance individualized care for patients with DRE.
Authors/Disclosures
Nishad Shaheid, MD (OhioHealth Mansfield)
PRESENTER 		Dr. Shaheid has nothing to disclose.
Darin Zahuranec, MD, MS (University of Michigan Health System) The institution of Dr. Zahuranec has received research support from NIH.
Lesli E. Skolarus, MD, MS (Northwestern University) Dr. Skolarus has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. The institution of Dr. Skolarus has received research support from NIH.
Chloe E. Hill, MD (University of Michigan) The institution of Dr. Hill has received research support from NIH. The institution of Dr. Hill has received research support from Â鶹´«Ã½Ó³»­. The institution of Dr. Hill has received research support from NIH. Dr. Hill has a non-compensated relationship as a member of Â鶹´«Ã½Ó³»­ Health Services Research Subcommittee with Â鶹´«Ã½Ó³»­ that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.