Abstracts

Rationale: Seizure action plans (SAP) were designed to help adult epilepsy patients and families better self-manage their epilepsy, but have not been validated in pediatric epilepsy patients. We hypothesized providing patients with a SAP would reduce healthcare utilization and improve quality of life (QOL). Methods: We created a pediatric SAP modelled after an existing asthma action plan. Pediatric epilepsy patients were stratified based on seizure frequency and randomized to receive a SAP in addition to standard care versus the standard care alone. Parents completed the Modified Impact on Families (MIF) questionnaire at enrollment and at 3 and 12 months. Healthcare utilization as well as MIF scores were compared between the two groups. Results: Parents of 102 pediatric epilepsy patients enrolled in the study and completed the initial survey. A one-way ANOVA test showed no statistically significant differences in healthcare utilization between the SAP (M=.65, SD=1.76) and control (M=1.15, SD=2.05) groups (p=.19). However, a trend toward decreased utilization was noted in patients receiving the SAP. Results of a repeated-measures ANOVA, comparing the SAP and control groups on various factors of the MIF over three time points, showed marginally-significant differences between and within groups on the "general" and "total" MIF impact sub-scores, such that the intervention was effective at initially lowering impact, but waned over time (Wilks lambda=.90, p=.123; Wilk's lambda=.81, p=.03, respectively). Conclusions: A trend toward decreased healthcare utilization and a significant decrease on initial impact of epilepsy on families was noted for patients receiving the SAP. The results may be clinically relevant, as any decrease in healthcare utilization is an important marker of improved quality of care and decreased healthcare costs. In addition, initially the impact of epilepsy on families is lessened which demonstrates an improved patient/caregiver experience. A SAP may still be beneficial for certain patients. More research, including the addition of covariates, to identify which patients might benefit from this tool is needed. Funding: There was no internal or external funding support for this work.