Abstracts

Rationale: There is a dearth of information on disparities of patients with epilepsy and, foremost, of their caregivers. The objective of this study is to compare patients with low socioeconomic status (SES) attending a county hospital epilepsy clinic with patients of higher SES attending an academic center epilepsy clinic for disparities in health care use/access, knowledge/attitudes towards epilepsy and epilepsy related outcomes. Methods: Patient and caregivers attending the study sites completed surveys about the aforementioned outcomes of interest. Associations were evaluated using income as a continuous independent variable and the outcomes of interest as dependent variables (Wilcoxon rank sum test for categorical variables and Spearman correlation coefficient for continuous variables). Results: 34 patients and 18 caregivers have been recruited thus far (ongoing enrollment). The majority of patients are on average 38 years old, single women, employed, with some college education. Half are African American and approximately half are Medicaid insured or uninsured. The majority have had epilepsy for 22 years averaging 4 seizures per month and are maintained on >/2 AEDs. The majority of the caregivers are first degree relatives with a mean age of 45 years, married employed women of higher educational attainment, typically cohabitating with the patients. Low income households were noted mostly commonly in African Americans (p=0.01), patients with poorer educational (p=0.03) and employment (p=0.04) attainment, worse insurability (p=0.0008) and suboptimal compliance to medications (p=0.06). Low income was also associated with lower quality of life (particularly in the social functioning domain, rs= 0.4, p=0.04), higher patient anxiety (rs=0.4, p=0.04), higher caregiver depression (rs=0.35, p=0.05) and lower patient (rs=0.37, p=0.05) and caregiver (rs=0.5, p=0.09) epilepsy knowledge. Conclusions: There are significant disparities in patients of different SES with epilepsy and their caregivers. Identification of those disparities is a critical step in the creation of appropriate interventions to address them. Funding: None