Abstracts

Rationale: Seizure clusters and status epilepticus are common in patients with epilepsy and are a significant cause of morbidity and mortality. One method of preventing and mitigating epilepsy emergencies is through individualized seizure action plans (SAPs). SAPs can improve patient and family awareness of seizure emergencies and facilitate early recognition and treatment. Despite their ability to guide care in emergencies, seizure action plans are underutilized among adult patients. Currently, there is no standard method of addressing rescue medication plans in adult clinical settings. This study aimed to identify barriers to use of rescue medications among adult epilepsy patients at risk for seizure emergencies.

Methods: A literature review was performed on Seizure Action Plans (SAPs), seizure rescue medications,, and their associated side effects to better understand how SAPs are used clinically as well as how patients respond to them. Using current information about SAPs, a survey intended for phone interviews was created. This survey consisted of 11 questions regarding rescue medication and SAP awareness as well as adherence. Both surveys consisted of a Likert scale and free-response questions to collect qualitative and quantitative data regarding SAPs and rescue medication adherence. Patients with a history of status epilepticus and seizure clusters were contacted by phone for detailed interviews regarding attitudes toward and knowledge of seizure action plans and rescue medications.

Results: Thirty patients participated in phone interviews. Sixty-five percent of patients were aware of rescue medications but only 42.3% knew what seizure action plans were. Sixteen of 30 (53%) responses identified significant obstacles to the rescue medication plan. A Pareto Chart and a bar graph were created to identify patients’ main difficulties with using rescue medication and adhering to their seizure plan, The main concerns were relying on others being around in the case of a seizure and informing others about what steps to take in the case of a seizure. The other concerns patients voiced were the side effects that occurred post-seizure, the inability to drive to the pharmacy or receive prescriptions for rescue medications, and the unpleasant taste of the rescue medication. 

Conclusions: Conclusions: This study provided quantitative and qualitative evidence of lack of knowledge about SAPs and rescue medications among adult patients with epilepsy. Despite high effectiveness of rescue medications, many adult patients with an indication for rescue medications remain unaware of these treatments, and lack written instructions on how to respond to seizure emergencies. Further research should focus on interventions to promote use of rescue medications among adult patients with epilepsy, such as standardized educational materials for patients and caregivers, use of written seizure action plans, and instructions about potential adverse effects of rescue medications.

Funding: Epilepsy Foundation, Epilepsy Learning Healthcare System