Abstracts

Rationale: A combination of TH and face-to-face clinic visit options seems to be the ideal care model for epilepsy patients who often cannot drive, may need assistive devices and/or specialized vehicles, may require multidisciplinary care, and/or may have to travel long distances to obtain the subspecialty care they need.

Previous studies have described the cost savings with TH appointments, and these savings may vary by geographic region. Also, it is unclear if epilepsy patients receive similar quality of care with these two visit types.

This is a sub-analysis of a prospective case (telehealth clinic=TH) versus control (face to face clinic=F2F) study involving epilepsy patients, their legal guardians, and caretakers who attend clinic. In this sub-analysis we compared severity of epilepsy, distance traveled, time off work, satisfaction of care, and aggressiveness of care (changes in medication or ordering of medical tests) with these to two visit types.

Methods: IRB approval was obtained for this study. Adult epilepsy patients, as well as legal guardians or caretakers of adult and pediatric patients attending either F2F or TH visits at Advent Health Epilepsy at Orlando clinic were invited to participate in a one-time telephone survey study after review of informed consent form. Categorical variables were evaluated with chi-square test.

Results: A total of 101 subjects were enrolled in this sub-analysis including 55 legal guardians, 34 patients and 12 caretakers. Subjects were recruited from 84 clinic encounters and 2 subjects enrolled from 17 of the encounters. Of the 101 subjects, 34 participated in a TH visit and 67 participated in a F2F visit. During the 84 visits, the average patient age was 26.4 years (10 months-79 years) with 58 females and 44 males seen.

None of the TH subjects reported any distances travelled to participate in their clinic visit. F2F clinic subjects travelled a range of 1.3-520 miles with an average distance 36.9 miles and median distances of 17.3 miles. Keeping in mind only adults completed the survey, 36 of 67 (53.7%) of F2F visit subjects were employed, and 19 of 34 (55.9%) TH visit subjects were employed (p=0.837). A total of 21/36 (69.7%) employed subjects requested time off from work for F2F clinic visits, and 9/19 (47.4%) TH employed subjects requested time off work (p=0.11).

Regarding seizure severity, 61.2% of F2F patients and 66.7% of TH patients had seizures within the last 6 months. Subjects rated visit satisfaction 1—6 with 1 being “extremely unsatisfied” and 6 being “extremely satisfied.” The average score was 5.6 for F2F subjects and 5.6 for TH subjects.

In the F2F visits the patient’s seizure medication was changed according to 30.3% of respondents compared to 33.3% in the TH group. Additional medical testing was ordered in 43.1%% of F2F visits and 33.3% of TH visits (p=0.35).

Conclusions: Care satisfaction was equal with both visit types. Though not statistically significant, a lower percentage of employed TH subjects took time off work to attend their visit. No TH subjects travelled for their visit and the median distance was 17.3 miles for F2F subjects. No significant difference was seen in aggressiveness of care between the two groups.

Funding: Please list any funding that was received in support of this abstract.: none.