Barriers to adherence to neurology clinic appointments for children with epilepsy – A pilot study
Abstract number :
196
Submission category :
17. Public Health
Year :
2020
Submission ID :
2422543
Source :
www.aesnet.org
Presentation date :
12/5/2020 9:07:12 AM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Jason Bailey, Dayton Children's Hospital; Gogi Kumar - Dayton Children's Hospital; Raj Kumar Agarwal - Dayton Children's Hospital; Melanie West - Dayton Children's Hospital;
Rationale:
Lack of adherence to neurology clinic appointments reflects missed opportunity to provide care for children with epilepsy. The objective of this study was to identify social determinants of health (SDH) and other factors associated with non-adherence to office visits in children with epilepsy
Method:
This was a prospective study conducted in the neurology division at a level 4 epilepsy center. Children (0 to < 18 years of age) with a diagnosis of epilepsy were included and a semi-structured questionnaire was provided to the families. Patients with two or more missed neurology clinic appointments in the previous year (“study group”, n=36) were compared to those with 1 or less missed appointments (“control group”, n=49). A comparison of the clinical characteristics, emergency room visits and hospitalizations in the past year as well as SDH was performed. Statistical analysis was performed using IBM SPSS v26.0 for Windows and p< 0.05 was considered significant.
Results:
The mean age, gender distribution and presence of medical refractoriness were comparable between the two groups. There was no difference in the perceived difficulty in keeping neurology appointments (16/36 vs 26/49, p=0.867) or scheduled frequency of neurology visits (frequency matched patient’s needs: 31/36 vs 45/49, p=0.643) between the study and control groups. There was no significant difference reported in the need for special arrangements for transportation (9/36 vs 6/49, p=0.127), lodging (2/36 vs 0/49, p=0.176) and childcare (5/36 vs 11/49, p=0.318). Families in the study group reported a higher likelihood of having to make special work arrangements for clinic appointments (28/36 vs 28/49, p=0.0045). Children in the study group were noted to have a higher frequency of single mother households (24/36 vs 17/49, p=0.002), presence of public insurance (30/36 vs 21/49, p< 0.001), father not graduating from high school (12/29 vs 3/42, p=0.001) and household income less than 10,000 dollars (8/31 vs 3/42, p=0.005). Within the preceding year, children in the study group were also noted to have a higher frequency of visits to the emergency department (3.1 visits vs 1.6 visits, p=0042) as well as six times higher likelihood of inpatient hospitalization for seizures.
Public Health