Abstracts

Rationale: The purpose of this project was to improve self-management skills in children with epilepsy and their parents through implementation of a seizure action plan (SAP) protocol with modular education. The current standard of care involves quickly providing verbal epilepsy education at the end of complex visits, with no written resources or direct guidance on SAPs. SAPs are typically completed during administration time by providers and sent to schools without family review. This results in gaps in epilepsy self-management leading to increased anxiety, frequent calls and incorrect medication administration. Providers often revisit basic epilepsy education, decreasing time for other aspects of epilepsy care potentially increasing emergency visits due to lack of adequate self-management.

Methods: The target population was children with new or existing epilepsy ages 7-18 and their parents in an outpatient neurology practice in Florida. Exclusion criteria included non-English speaking patients or those unable to complete questionnaires. Self-management was measured using valid and reliable measures in the Pediatric Epilepsy Medication Self- Management Questionnaire (PEMSQ) for parents and Seizure Self Efficacy Scale for Children (SSES-C). Once deemed not to be human subjects research by the institutional review board, baseline self-management scores were identified for children and their parents using the questionnaires. An assessment was then conducted to create an individualized, evidence-based SAP. Parent-child dyads were educated using modules based on best practices in the literature. Reassessment occurred at follow-up visit 30 to 90 days later depending on recency of the epilepsy diagnosis. Pre- and post-intervention scores were then compared to assess for changes in self -management scores.

Results: For children, self-management skills medians scores on the SSES-C increased from 4.0 to 4.53 and were statistically significant (p < .025; n = 16). The pre-intervention interquartile range (IQR) was 1.4 and post-intervention IQR was 1.0. In the parents, median scores on the PEMSQ increased from 120 to 129, however, results were not statistically significant (p < 0.064; n = 16). The pre-intervention IQR was 21.5 and post -intervention IQR was 12. Three of the dyads did not complete questionnaires and are not included in the analysis.