Abstracts

Rationale: Ketogenic Diets have shown adequate efficacy in adults with refractory epilepsy. Despite promising results, adherence to these diets remains a major barrier to its effective use and implementation. The aim of this study was to survey adult patients with refractory epilepsy placed on a ketogenic diet to assess demographic and socio-economic factors associated with KD adherence.

Methods: A phone survey of English-speaking patients aged 18 years and older with refractory generalized and focal epilepsy seen at a ketogenic diet clinic in an urban community hospital who were started on ketogenic diet between September 2017 to January 2020 was conducted. Patients were included if they had at least 3 months follow-up after initiation of the KD. Patients with significant cognitive deficits were excluded from the study. The survey included questions aiming at correlating adherence to age, side effects, cost of diet, food option availability, and family support.

Results: A total of 70 patients were identified, 67 met the inclusion criteria. Of those, 35/65 (54%) gave consent to participate. The average age was 42.3+11.9 years. Other sample characteristics included female (71.4%), white (88.6%), married (60%), with some college education (37.1%) at 3 months follow-up (Table 1). Over 75% (27/35) of the patients were adherent to the KD at 3 months. Patients who were adherent to the diet were significantly younger than the non-adherent patients, respectively (39.7+10.2 v 50.9+13.6; p=0.017). There were no other factors that were significantly associated with adherence at 3 months (Table 2). However, the adherent group also had higher rates of females, educated individuals, as well as lower rates of married participants, though not statistically significant. At the time of the phone interview, 44.4% (12/27) were still adherent to the diet, 11 were adherent for more than 1 year. Of the non-adherent patients, factors related to stopping the diet included financial difficulties (3 patients), diet restrictiveness (1 patient), time for food preparation (1 patient), and lack of support by friends/family (1 patient). Reported side effects included hypercholesterolemia by 1 patient

Conclusions: Our results suggest that age may influence adherence to the KD. In our study, younger patients were more likely to adhere to KD. However, other factors may play a role and should be investigated with a larger prospective study. Clarifying factors related to adherence to KD could assist with identifying the best candidates for KD initiation and defining areas for potential interventions in improving compliance.

Funding: Please list any funding that was received in support of this abstract.: N/A.