Abstracts

Rationale: Epilepsy is associated with significant impairments in cognitive, psychological, and social functioning, as well as increased risk of death. These consequences are magnified in patients with treatment-resistant epilepsy (TRE). Many neurologists lack both knowledge and confidence in the use of treatment strategies designed to maximize the chances of achieving seizure freedom. A study was undertaken to evaluate the effectiveness of short (15 minutes) online educational intervention to improve the competence and confidence of neurologists as it relates to the selection of antiseizure medications (ASMs) in patients with TRE who either are or are not candidates for a surgical intervention.


Methods: The online continuing medical education (CME) activity format consisted of a 15-minute video discussion between two epileptologists. Educational effect was assessed by comparing a matched sample of neurologists’ responses to four identical questions presented before and directly after exposure to the intervention. A paired samples t-test was used for overall average number of correct responses and for confidence rating and a McNemar’s test was used to identify significant differences between pre- and post-assessment question responses. Cohen’s d was used to calculate the effect size of the online education. Data from the participants were collected between June 19, 2023 and August 29, 2023.


Results: A total of 87 neurologist learners were included in this analysis and participation in the education resulted in a moderate educational effect (d=0.72; p< 0.001). The following areas showed significant (P < .05) pre- vs post-educational improvements: selection of a different ASM in a patient who experiences behavioral adverse events to their current treatment regimen, selection of an ASM in a patient with TRE who is not a candidate for epilepsy surgery, and selection of an appropriate ASM for a patient who experiences seizures a year after epilepsy surgery. After participating in the activity, 31% of neurologists reported increased confidence in their ability to select an appropriate pharmacotherapeutic treatment regimen to optimize seizure control in patients with treatment-resistant epilepsy.


Conclusions: The results indicated that a short CME-certified video-recorded discussion between physician experts was able to improve the ability of neurologists to personalize the selection appropriate ASMs for patients with TRE. Future educational effort should continue to address the spectrum of case scenarios in TRE for which clinicians will need to make treatment decisions.


Funding: The CME activity and outcomes analysis referenced in this abstract was supported by an independent educational grant from SK Life Science, Inc.