Abstracts

Rationale:
Numerous issues affect the quality of life (QOL) of people living with epilepsy such as side effects of medications, mood changes, stigma, lack of social support, and employment barriers1. Understanding the broader QOL issues of epilepsy patients such as satisfaction with housing, education, and ability to help others can help guide treatment and program services2. A multi-step treatment approach that evaluates frequency, severity, duration of seizures, along with QOL relief therapies tailored to the patient may be most beneficial to improving patient outcomes3. In medicine, there is an emphasis on patient-centered care including ensuring that patient’s values guide clinical decision-making. Despite ample investigations of factors that may affect quality of life in people with epilepsy, there are limited studies specifically seeking an understanding of what patient’s value most. The objective of this study is to survey patients with epilepsy to identify their top three values in relation to their general epilepsy management.
Method:
A twelve question survey was designed by the Comprehensive Epilepsy Program at the University of Florida Health Jacksonville (UFHJ). The survey consisted of demographic and value questions. Adult subjects diagnosed with epilepsy for at least 6 months (focal or generalized epilepsy) on anticonvulsant medication(s) were included. Subjects with a physical or cognitive limitation that prevented them from completing the survey or a previous stroke or brain tumor were excluded. The survey was conducted anonymously following a routine clinic visit. The University of Florida Institutional Review Board (IRB) approved this study. Results55 subjects were included; characteristics are summarized in Table 1a. During the survey, each subject rated different values for importance such as seizure reduction, being able to work, managing stress, preventing memory issues, promoting sleep, and minimizing medication side effects. This was rated as most important, second most important, and third most important; Figure 1 depicts these results. Seizure reduction and being able to work were the most commonly chosen most important value (n=15 for each value). There was a gender disparity in this result with 67% of women choosing being able to drive as their most important value and 60% of men choosing seizure reduction as their most important value (Table 1b). There were also racial and income disparities that affected the choice of the most important value as noted in Table 1b. Statistical analyses were unable to be conducted due to low sample sizes.
Conclusion:
Patient-centered care is beneficial to an epilepsy patient’s treatment plan and improves the quality of care. It is important to consider the demographics of the patient as socioeconomic status, race, and gender may affect values. Our study suggests that white, higher income women are more likely to choose being able to drive as their top value while black higher income men are more likely to choose seizure reduction as their top value; notably, small sample sizes limit the overall significant of these results and further studies are required to clarify these findings.
Funding:
:None References: 1. England MJ. Institute of Medicine committee of the public health dimensions of the epilepsies. Epilepsy across the spectrum: promoting health and understanding. Washington DC: National Academies Press, 2012. 2. Kobau R, Luncheon C, Zack MM, Shegog R, Price PH. Satisfaction with life domains in people with epilepsy. Epilepsy Behav. 2012;25(4):546-551. 3. D’Cruz O. Outcome-centered antiepileptic therapy: Rate, rhythm and relief.: Implementing AAN Epilepsy Quality Measures in clinical practice. Epilepsy Behav. 2015;53:108-111.