Rationale: Epilepsy is associated with significant impairments of cognitive, psychological, and social functioning, as well as increased risk of mortality. Despite the extensive negative health-related impact of epilepsy, patient care is suboptimal. Contributors to suboptimal care include the lack of both seizure action plans (SAPs) and the prescribing of seizure rescue medications for appropriate patients. This study was developed to assess the ability of an online medical education program to encourage practice changes related to the development of SAPs and the prescription of seizure rescue medications among neurologists, PCPs/pediatricians, and NP/PAs.
Methods: The online CME activity consisted of a 5-module, 60-minute video discussion between epilepsy experts that addressed distinct aspects of either seizure action plans or seizure rescue therapies. Learners needed to watch all 5 segments in order to receive CME credit. The impact of the activities on self-reported practices related to the development of a seizure action plan and prescription of seizure rescue medications was measured using intent to change, a validated surrogate measure for actual changes in clinical practice. Learners were asked to identify intended changes and barriers immediately after program completion.
Results: A total of 144 neurologists, 127 PCPs/pediatricians, and 1,874 nurses/NPs/PAs learners provided immediate post-activity feedback on the intention to make practice changes and barriers that may prevent their implementation. The results of the immediate post-activity survey indicated:
- 53% of neurologists, 43% of PCPs/pediatricians, and 36% of nurses/NPs/PAs reported that they plan to include information about epilepsy type and how to address the occurrence of seizures in a SAP
- 63% of neurologists, 43% of PCPs/pediatricians, and 38% of nurses/NPs/PAs reported that they plan to recommend rescue therapy for patients at risk for developing status epilepticus
- 59% of neurologists, 37% of PCPs/pediatricians, and 27% of nurses/NPs/PAs reported that they plan to increase the utilization of nasally administered seizure rescue therapies
- 59% of neurologists, 43% of PCPs/pediatricians, and 40% of nurses/NPs/PAs reported that they plan to educate patients and caregivers on the administration of rescue therapies
- The most commonly noted perceived barriers for implementing the noted changes across all clinician groups included: Financial/reimbursement issues and lack of time to develop or modify a SAP
Conclusions: Online CME-programming encourages clinicians to make changes to their practice specific in relation to the development of SAPs and the use of nasally administered seizure rescue medications. Future education should continue to address the importance of seizure action plans and the selection of appropriate seizure rescue medications, in addition to addressing the identified barriers to practice change.
Funding: Please list any funding that was received in support of this abstract.: The education and outcomes analysis was supported by an independent educational grant from Neurelis, Inc.