Abstracts

Rationale: Epilepsy is a common neurologic condition, and appropriate diagnosis, management and counseling can improve quality of life in patients and their families. In 2011, the American Academy of Neurology (AAN) and the American Medical Association (AMA) developed eight quality measures for patients with epilepsy. These were updated in 2014. These measures include documentation of seizure type and frequency; etiology or epilepsy syndrome; EEG and neuroimaging findings; antiepileptic drug side effects; safety issues; behavioral health; referral for refractory epilepsy, and issues for women of childbearing potential. Prior studies evaluating adherence to 2011 epilepsy quality measures showed overall better adherence to objective measures (seizure type/frequency, EEG, imaging) than to counseling (safety measures). As proper documentation of all issues discussed during a visit is important, using an electronic template is beneficial. Our epilepsy clinic employs a template addressing the 2011 epilepsy quality measures. This template has not yet been integrated into the general neurology clinic notes. Methods: A retrospective chart review was conducted for patients seen in the general neurology and epilepsy clinics between July 2015 and March 2016. 30 charts were randomly selected from each of these clinics. Demographics and adherence to quality measures were assessed using SPSS software. P-value less than 0.05 was considered statistically significant. Results: Adherence to quality measures was significantly different between the epilepsy and neurology clinics (See Table). Difference in epilepsy surgery referral and bone health counseling could not be assessed due to small sample size. The epilepsy clinic did better in counseling child bearing women, epilepsy safety issues, anti-epileptic drugs, documenting epilepsy etiology and imaging results. Counseling regarding behavioral health was better in the general neurology clinic. Both clinics did well in documenting seizure type and frequency. Conclusions: There were significant differences in adherence to epilepsy quality measures between the general neurology and epilepsy clinics. Counseling about behavioral health and bone health from 2014 quality measures were not included in the epilepsy clinic template. Adherence to these measures was lacking in both clinics. Utilization of a template updated to include 2014 recommendations will improve the adherence to quality measures in both epilepsy and neurology clinics. Funding: No funding received.