Abstracts

Rationale: The overall prevalence and implications of emergency care plans for patients with epilepsy is not well understood. The purpose of this study is to identify the frequency of seizure-related emergency care plans and to describe content within these plans.Methods: A cross-sectional, web-based survey was conducted among adults with epilepsy. Respondents were recruited from the Harris Interactive online chronic illness panel. Inclusion criteria were diagnosis of epilepsy, currently taking an anti-epileptic drug (AED), and aged 18 - 64 years. These data were weighted to represent the general population of patients with epilepsy in the US. Data were collected on presence and content of seizure plans, seizure control, and numerous epilepsy specific health outcomes. All statistical testing was performed with alpha<0.05.Results: Data were analyzed from 408 adults with epilepsy, 30% of respondents reported having a “seizure plan” (defined as a plan, recommended by the physician, of what to do when a seizure occurs). Of those with seizure plans, 74% reported always following the plan, with 26% stating sometimes following the plans. Those with plans (68%) are significantly more likely to have experienced a loss in seizure control when compared to those with no seizure plan (42%) (p<0.05). Respondents with a seizure plan were more likely to have visited the emergency room as a result of a seizure (81%), when compared to respondents without a seizure plan (64%) (p<0.05). When asked if respondents had been hospitalized, those with a seizure plan were more likely to report being hospitalized than those without plans (62% vs. 48% respectively, n.s.). Respondents without a plan are more likely to report that their seizure frequency had decreased as a result of their current medication (71%) when compared to those with a seizure plan (56%) (p<0.05). Significantly more respondents with plans have also experienced a loss in driving ability (46%), sustained injury during a seizure (32%), experienced job loss (25%) and depression (23%) in comparison to those with no seizure plan (17%, 13%, 13%, 10% respectively) (p<0.05). Interestingly, those with seizure plans also are more than four times more likely to use alternative diet regimens to treat their epilepsy (p<0.05). Seizure plan descriptions varied widely, however the most commonly reported components were: rest/relaxation/sleep (32%), calling an ambulance or 911 (19%), avoidance of head and body injury, turning on side, using bite stick (18%), and move to a safe place (8%).Conclusions: These findings indicate that seizure plans are not that commonly implemented in patients with epilepsy, and may only be designated in patients with severe disease. Among the patients with seizure plans, the extent of the plan and restriction of activities was significantly variable. This study suggests the need for a more standardized disease management protocol across all patient severity types to help patients and families more effectively cope with seizures. Sources of funding: GlaxoSmithKline