Abstracts

Rationale: The National Coordinating Center for Epilepsy (Center) at the American Academy of Pediatrics supports seven Transforming Health Care for Children and Youth with Epilepsy grantees in meeting deliverables set by federal funding provided by the Health Resources and Services Administration–Maternal and Child Health Bureau (HRSA-MCHB). A key project aim is to improve the quality of care for children and youth with epilepsy (CYE). Increasing primary care provider (PCP) knowledge, confidence, and care coordination abilities is critical to improving the overall quality of care for CYE. As part of the support provided by the Center to grantees, Center staff host a bi-monthly learning collaborative and provide individualized technical assistance as requested. Learning collaborative meetings include speakers, presentations, and workshops related to the epilepsy care project priority areas of telehealth, health care transition, shared decision-making, and care coordination.

Methods: The Center conducts a yearly cross-sectional study to assess progress toward project aims. Annually, PCPs affiliated with the Transforming Health Care for CYE project are invited to complete an anonymous electronic survey. The survey instrument collects self-reported PCP data regarding knowledge, confidence, and care coordination pertaining to health care for CYE. Year 1 data collection occurred between June 1 and December 15, 2020, and 42 PCPs completed the survey. Year 2 data collection occurred between June 1 and September 1, 2021, and 98 PCPs completed the survey. The individual items were totaled to create a score for each category. The knowledge score consisted of eight items, confidence eleven, and care coordination four. Each item was assessed on a four-point Likert scale with anchors at each point. A Mann-Whitney U test was used to compare Year 1 responses to Year 2. The statistical analysis was done on IBM SPSS version 25._x000D_
Results: PCPs reported gains in key areas of knowledge and confidence in epilepsy care. Statistically significant knowledge gains were reported from PCPs in Year 2 compared to Year 1 (z = 3.326, p = 0.001, N = 131). Increased confidence in providing care to CYE patients was reported in Year 2 compared to Year 1 of the project, but it was not statistically significant (z = 1.573, p = 0.116, N = 130). Additionally, PCPs reported greater care coordination with specialists in Year 2 compared to Year 1, but this was also not statistically significant (z = 0.826, p = 0.409, N = 124).

Conclusions: The learning collaborative demonstrated that epilepsy‐specific content and quality measures in primary care practices can increase PCP epilepsy knowledge, which may lead to improved care for CYE patients. Additional work remains to be done to improve PCP confidence in providing care to CYE and coordinating care with specialty care providers. It is imperative to have a pediatric primary care workforce able to care for CYE patients in a knowledgeable, confident, and coordinated manner.

Funding: This project is supported by HRSA MCHB under grant number U23MC26252.