Abstracts

Rationale: Several adjustments of antiepileptic drug (AED) treatment may be required before one can attain seizure-freedom with no or minimal side effects, especially with drug-resistant epilepsies. A telephone nursing line in a hospital-based epilepsy clinic can aid in the provision of care. To identify areas for improvement, a prospective audit of our epilepsy clinic hotline was carried out to determine patient expectations, delivery of care, patient satisfaction and impact (on use of healthcare resources). Methods: Between March 2011 and May 2012, patients calling the epilepsy clinic hotline for notification of seizures or side effects were asked to participate in this survey. The survey included 9 questions evaluating the patient's expectations regarding acceptable delays to return calls and modify their treatment, level of satisfaction and what they would have done were the hotline was unavailable. A Likert scale was used to determine patient satisfaction. Call time, call motive, call return time and medication modification time, if applicable, was tabulated for patients. Results: In the study period, 79 patients who used the epilepsy hotline agreed to complete the survey. Sixteen percent of patients expected to have their call returned within 8 hours and more than half of patients (57%) within 24 hours. In reality, while the majority of calls (78%) were answered within 48 hours, only 54% were called back within 24 hours. Despite this slightly longer than desired delay, 91% of patients strongly agreed (68%) or agreed (23%) that the actual response time was satisfactory. With regards to treatment modification, patients generally expected a medical prescription within 24 (42%) or 48 hours (33%), followed by 72 hours (16%), less than a week (5%) and more than a week (5%). Only a minority found that a one-week delay was acceptable for a medication modification (5%). Would the hotline service not exist, 87% said they would have tried to have their medical appointment moved up. If the latter was not possible, more than half (69%) would have gone to the E.R and 18% to the family physician. A few patients would have changed their medication themselves (6%) or wait for the next medical appointment (5%). Finally, most agreed (88% strongly agree, 7% agreed) that a telephone nursing line greatly contributed to the overall satisfaction of the epilepsy clinic. Conclusions: Patients using the epilepsy clinic hotline generally expect an answer within a day and treatment modification within 2 days. While these expectations are not fully met in time, the hotline is still well appreciated and can potentially reduce the number of ER visits.