Abstracts

Rationale: Prevalence of epilepsy is high in LTC and group home residents. Epidiolex^®, a plant-derived, highly purified pharmaceutical formulation of CBD is approved for the treatment of seizures associated with Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex in patients ≥ 1 year of age and has demonstrated real-world effectiveness in both seizure and nonseizure outcomes in outpatient settings. Real-world effectiveness of CBD in LTC residents has not been studied. BEhavior, COgnition, and More With Epidiolex^® in the Long-Term Care Setting (BECOME-LTC) survey evaluated nurses’ perspectives of the outcomes associated with CBD treatment in the LTC setting.


Methods: Nurses actively working in an LTC, community independent living arrangement/group home, or an intermediate care facility in the United States completed an online, 25-minute multiple-choice survey. The main objective of the survey was to assess changes in seizure frequency and nonseizure outcomes, including communication, cognitive ability, sleep, and emotional and physical functioning after initiation of CBD (Epidiolex^®; 100 mg/mL oral solution) treatment in LTC residents with epilepsy. Nurses ranked their impression of change in outcomes using a symmetrical Likert scale (from worsening to improvement).


Results: A total of 102 nurses completed the survey. Most participating nurses were ≥ 35 years old (87%), were female (85%), cared for > 5 residents with seizures (64%), and had > 10 years of nursing experience (68%); 61% of the nurses were caring for up to 3 residents receiving CBD treatment. Most nurses (58%) worked in facilities with a total capacity of > 50 residents per facility. Community independent living arrangement/group home was the most common type of resident facility (reported by 42% of nurses). Reduction in overall frequency of any seizure after CBD initiation was reported by 85% of nurses, with 49% reporting ≥ 50% reduction; 9% reported no change and 6% reported worsening in any seizure frequency. Improvements were observed across seizure types, with 77% of nurses reporting reduction in convulsive seizures, 72% in drop seizures, 66% in nonconvulsive seizures, and 65% in nondrop seizures. Across seizure types, no change in seizure frequency was reported by ≤ 29% of nurses and worsening by ≤ 9% (Fig 1). Improvements were also reported in nonseizure outcomes, with 75% of nurses reporting improvements in emotional functioning, 61% in sleep, 60% in cognitive abilities, 42% in ability to communicate, and 40% in physical functioning. No clear change was reported by ≤ 57% of nurses and worsening by ≤ 4% across the nonseizure-related domains (Fig 2).


Conclusions: In this analysis of BECOME-LTC survey, 85% of nurses reported improvements in seizure frequency and up to 75% reported improvements in nonseizure outcomes among residents receiving CBD treatment in the LTC setting. The results suggest benefits of CBD treatment in residents with epilepsy in LTC facilities and group homes and support further evaluation of CBD in this setting.


Funding: Jazz Pharmaceuticals, Inc.