Abstracts

Rationale: Epilepsy is one of the most common neurological diseases, affecting over 3.4 million people in the US and 110,100 people (nearly 95,000 adults) in North Carolina (NC). The annual estimated costs associated with this disorder are $15.5 billion (Centers for Disease Control and Prevention (CDC). Among the costs, inpatient care cost accounts for the largest portion. This cost can be significantly reduced by improving self-management and education among patients and their families. Self-management in epilepsy and psychosocial care have been studied mainly in outpatient setting but not in the Epilepsy Monitoring Unit which is an inpatient seizure ward unit. Thus, we evaluated various self-management, self-efficacy, psychosocial screen and quality of life in EMU at UNC. Methods: Consecutive 23 EMU patients were surveyed for quality of life, depression, anxiety, self-management skill, self-efficacy skill, stress, stigma and social role and activity with the batteries of QOLIE-10, PHQ-9, GAD-7, Epilepsy Self-Management (ESM), Epilepsy Self-Efficacy Scale (ESES), Neuro-QoL Anxiety, Depression, Perceieved Stress, Stigma, Social Role and Activity as part of routine psychosocial screen by an epilepsy social worker from March 2019 till May 2019. Results: Demographic information shows 10 female and 13 male patients participated. Mean age is 37.4 years old. Fourteen patients have some college education. The mean and standard deviation in each domain is demonstrated in Table 1. For Epilepsy Self-Management scale, the mean (SD) in each domain of Medication management, Information Management, Safety Management, Seizure Management and Lifestyle Management is 2.32 (0.32), 2.18 (0.54), 2.48 (0.30), 4.28 (0.49), 3.10 (0.71).Our inpatient EMU patients appear to have greater psychiatric burden and worse self-management/ self-efficacy skills than previously reported outpatient results from Managing Epilepsy Well (MEW) Network which showed the mean (SD) in each domain of PHQ-9, ESM, ESES is 2.8 (0.8), 9.8 (6.9), 3.7 (0.4), 7.91 (1.29). Quality of Life in Epilepsy with QOLIE-10 showed similar result with mean 2.8 (SD 0.8). Conclusions: This discrepancy in psychiatric condition and self-management/ self-efficacy may partly due to the more severe epilepsy burden in EMU patients. This result demonstrates a different approach to this group of patients to improve overall quality of life with more focus on psychosocial care and education. Funding: No funding