Abstracts

Rationale: In the United States, approximately 150,000 new cases of epilepsy are diagnosed each year and is associated with marked morbidity and mortality. Selecting the appropriate antiepileptic drug (AED) is important for minimizing the impact of seizures on the health and well-being of patients, however, AED selection is often complicated by adverse event profile, patient age, and comorbid disease. Another factor that can negatively impact outcomes is poor patient understanding of epilepsy and AEDs. A study was undertaken to determine if online parallel physician-patient education interventions could increase the awareness of strategies designed to improve treatment outcomes in epilepsy. Methods: Two online CME activities were developed to focus on patient, disease, and medication factors for selecting AEDs. The first activity was a 30-minute video roundtable discussion among 3 faculty members; the second activity was a 30-minute video lecture with slides and commentary from a single faculty member. Both CME activities included a link to the same patient education module, developed to address issues relating to therapy with AEDs. For each CME activity, physician responses to questions were collected after the education (post-assessment) and compared with each user's baseline data (pre-assessment) using a 2-tailed paired t test. A comparison of pre- and post-education responses to the patient activity were assessed to measure improvement in knowledge. Data collection on the activities were as follows: roundtable discussion, August 31, 2015 and December 2, 2015; video lecture, September 25, 2015 and December 22, 2015; and patient activity, December 10, 2015 and February 2, 2016. Results: Responses from a total of 177 neurologists participated in the CME activities and total of 414 patient/caregiver participants who completed the education module and the pre- and post-education questions were analyzed. Participation in the CME activities demonstrated significant (P < .05) improvements in the following areas: AEDs with the lowest likelihood of depression as an adverse event (83% pre vs post relative improvement); balancing adverse events with efficacy in determining the speed of AED titration (15% pre vs post relative improvement); considerations for titration of AEDs in older adults (42% pre vs post relative improvement); the impact of comorbid mood disorders on the risk of AED-related psychiatric adverse events (82% pre vs post relative improvement); and selection of an appropriate AED in patients with a history of mood disorders (15% pre vs post relative improvement). A trend for significance (P=.06) was observed on the identification of AEDs with the lowest risk of cognitive deficits. There was an 11% relative improvement in patient/caregiver knowledge regarding the best approach to addressing breakthrough seizure activity (75% vs 83%). Conclusions: This study demonstrated that aligned physician-patient education is able to improve awareness of strategies to maximize the efficacy and safety of AEDs, which may help support shared decision making. Funding: The educational intervention, outcomes measurement, and abstract development were funded through an independent educational grant from Sunovion Pharmaceuticals.