Abstracts

Rationale: It is common for people with epilepsy (PWE) to present to the emergency department with their first seizure and to wait weeks/months to be seen by a specialized epilepsy provider. The time between presentation of first seizure and entry into specialized care can be precarious. To achieve optimal outcomes, epilepsy self-management should be initiated as soon as possible. Our prior work demonstrated that education materials provided to patients with new-onset seizures in emergency department settings nationwide were largely devoid of important self-management support. Findings of this prior study highlighted the need for development of robust self-management interventions tailored to PWE in the transition period from presentation of first seizure to entry to specialized care.
_x000D_ The purpose of the current study was to build a self-management intervention to meet this need. Specifically, we used a novel, two-pronged approach to develop a robust intervention for this population, basing its content on patient-centered areas of epilepsy self-management depicted in the Adult Epilepsy Self-Management Instrument (AESMMI), and developing that content using Patient Activation Theory (PAT), a strong predictor of self-management across chronic conditions. By combining the PAT and AESMMI, we sought to develop an intervention that would be maximally beneficial through its theory base and focus on evidence-based areas of self-management.

Methods: We used a combination of PAT and the AESMMI to build an intervention to bolster self-management; we chose to focus on four areas of self-management from the AESMMI that our prior work has demonstrated to be of importance to PWE (social support, coping, communication, and proactivity). We used a matrix intervention development technique to build informational, skill-building, and cognitive rehearsal content (per PAT) in these four self-management areas (See Table 1 for example). Three investigators participated in the development of each intervention matrix, and the team independently reviewed each self-management area, called a workshop, to ensure that all aspects of PAT (informational content, skill-building content, and cognitive rehearsal opportunities) were present for each self-management area.

Results: Matrices related to Social Support, Coping, Communication, and Proactivity were developed and are currently being transferred to a digital format for pilot testing with PWE new to epilepsy and seizures. In each of these workshops, participants will receive informational and skill-building content, as well as cognitive rehearsal activities to improve their Activation in each self-management area from the AESMMI.

Conclusions: The two-pronged matrix intervention development technique provided a systematic, rigorous method for intervention development to address the need for a theory-based, patient-centered self-management intervention for PWE new to epilepsy and seizures. When piloted, this intervention can provide PWE with theory-based (PAT) self-management development in evidence-based areas of epilepsy self-management (AESMMI).

Funding: This study is supported by UCB Pharma.