Abstracts

This is a Late Breaking abstract

Rationale: People with epilepsy (PWE) face many disparities in healthcare, including access to specialist care, management of comorbid mental health and medical conditions, socioeconomic challenges, access to community resources and poor social support among others. Standardized epilepsy self-management (ESM) programs have demonstrated benefit in health outcomes and quality of life for PWE. However, ESM practices and behaviors are less commonly implemented among PWE from underserved populations. PWE in the US receive care in diverse clinical settings: About 80% of adults have seen a general practitioner in the past year and 60% have seen a neurologist or epileptologist. This project aims to identify gaps in knowledge and confidence surrounding epilepsy care inclusive of ESM that exist among epilepsy specialist clinicians (ESC) and non-specialist clinicians (NSC) to inform targeted educational interventions which have potential to address gaps and improve care for PWE.

Methods: Two surveys were designed, one for ESC and one for NSC, to identify respondents’ perceived level of knowledge and confidence in practice about ESM, stigma, treatment and seizure first aid as well as the respondents’ self-rating of their knowledge and awareness of social determinants of health (SDOH) affecting epilepsy care. Face and content validity were established, and surveys were delivered electronically via REDCap. Data analysis was descriptive.

Results: A total of 276 responses from 38 states (167 ESC; 109 NSC) were analyzed. Strong correlation between knowledge and confidence was observed for both ESC (r = 0.91) and NSC (r = 0.89) across all epilepsy care domains surveyed. No statistical difference was observed in knowledge of ESM programs and referral to ESM programs among ESC provider groups. ESC subgroup analysis demonstrated a significant difference between epileptologists and neurologists (p < 0.0004) regarding knowledge for counseling patients on ESM skills (p < 0.002), knowledge of available ESM programs, (p < 0.02) and referral to < 0.001) ESM. Significant differences were observed between ESC and NSC regarding counseling patients on ESM skills (p < 0.0001), knowledge of available of ESM programs (p < 0.0006), and referral to < 0.008) ESM. Beyond ESM, statistically significant differences were seen between ESC and NSC in knowledge and confidence addressing SDOH in epilepsy (p < 0.0002) and creating culturally competent care plans (p < 0.0001); statistically significant differences were also seen in these domains of care when comparing epileptologists to neurologists (p < 0.02, culturally competent care plans; p< 0.0003, SDOH).