Patient-reported Outcomes in Epilepsy: Persistent Inequities and the Impact of Virtual Care
Abstract number :
3.158
Submission category :
17. Public Health
Year :
2024
Submission ID :
238
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Syed Ahsan, MBBS – Massachusetts General Hospital
Julianne Brooks, M.P.H. – Massachusetts General Hospital
Maria Donahue, MD – Massachusetts General Hospital
Aya ElHassan, BS – Massachusetts General Hospital
Aanchalika Chauhan, Undergraduate Student – Massachusetts General Hospital
Saiyid Ahmad Ali Naqvi, MBBS – Massachusetts General Hospital
Kathleen Farrell, MB BCH BAO – Epilepsy Foundation of America
Jeffrey Buchhalter, MD, PhD – University of Calgary
Brandy Fureman, PhD – Epilepsy Foundation
Peter Hadar, MD, MS – Massachusetts General Hospital and Harvard Medical School
Sydney Cash, MD, PhD – Massachusetts General Hospital and Harvard Medical School
Sahar Zafar, M.D., MSc – Massachusetts General Hospital
Lidia V.M.D. Moura, M.D., PhD, MPH – Massachusetts General Hospital
Rationale: Patient-Reported Outcomes Measures (PROMs) offer crucial insights into patients' health, identify gaps in care, and guide targeted interventions. While high digital health literacy improves virtual care use, evidence of its impact on PROMs tracking is limited. This study examined factors associated with PROMs completion in a tertiary epilepsy clinic post-virtual care implementation.
Methods: As part of a quality improvement initiative, the Epilepsy Learning Healthcare System (ELHS), we completed a retrospective analysis of patient visits in the Massachusetts General Hospital (MGH) Epilepsy Clinic from January 2019–May 2024. Epilepsy-specific PROMs questionnaires were assigned to all outpatient visits in the MGH Epilepsy Clinic as part of routine clinical care. We calculated the proportion of visits with completed PROMs and stratified them by demographics (age, sex assigned at birth, race, ethnicity, language), visit type (virtual vs. in-person, new vs. follow-up), calendar year (2019-2024), and provider type (providers affiliated to the ELHS vs not). We used standardized mean difference (SMD) to identify differences in proportions between groups.
Results: Of the 16,417 MGH Epilepsy Clinic visits between January 2019 – May 2024, 6,236 (38%) had completed PROMs. Sample demographics are in Table 1. PROMS completion rates were highest in New Patients-Virtual visits (69%), followed by Follow-Up-Virtual visits (43%), New-Patient-In-Person visits (35%), and Follow-Up-In-Person visits (27%) (SMD= 0.46) - Figure 1, Table 1. PROMs completion increased year-over-year, with the completion rate reaching 58% in 2023 (vs 23% in 2019, SMD =0.52) – Figure 1. Additionally, English-speaking patients had a higher rate of PROMs completion than Spanish-speaking patients (39% vs 15%, SMD= 0.19). For patients treated by providers involved in the Epilepsy Learning Healthcare System, PROMs completion rates were moderately higher (43% vs 35%, SMD=0.18).
Conclusions: Virtual care has been associated with an increased completion rate of PROMs in an epilepsy clinic, especially during new visits. Notably, persistent disparities among demographic groups highlight the need to address ongoing inequities in healthcare participation despite the effectiveness of virtual care.
Funding: No funding was received for this abstract.
Public Health