Abstracts

The number of seniors with epilepsy (SWE) will dramatically increase as the population ages. Therefore it is important for health care providers who care for SWE to understand the principles of diagnosis and treatment in this special population. Under the auspices of the Epilepsy Foundation, we conducted a web-based survey of practicing health care providers to ascertain their knowledge and practice patterns regarding SWE, and to identify their learning needs. A 55-question survey was designed based on 10 in-depth interviews and subsequently completed via the internet by 221 health care providers: neurologists (n=49), primary care physicians (50), geriatric nurse practitioners (50), geriatric psychiatrists (18), geriatricians (18), licensed practical nurses (LPN; 18), and emergency medicine physicians (18). Participants had a minimum of 3 years of practice, were not employed or otherwise paid by a pharmaceutical company except for clinical trials, and were board certified or eligible. The respondents were primarily based in private offices or hospital settings and cared for a substantial number of patients over the age of 65, including patients with epilepsy. A minority stated that the incidence of epilepsy was higher in patients aged 65 and over compared with younger patients. Nearly 1 in 4 primary care physicians indicated they do not routinely refer their senior patients suspected of having epilepsy to a neurologist. With the exception of neurologists and geriatric psychiatrists, a significant majority of providers acknowledged a low index of suspicion for the possibility of epilepsy in seniors who experience a first seizure. Up to 2 in 3 providers (LPN) did not think that patient history was absolutely necessary in the diagnostic evaluation of epilepsy in seniors. Phenytoin was listed by 31% of neurologists as their most common first line treatment for SWE compared with 79% of the non-neurologists. The majority of providers were very receptive to receiving further education as well as materials for their senior patients with epilepsy and their families. This web-based survey identified significant knowledge gaps among a sample of health care providers who routinely care for seniors with epilepsy. The findings suggest the need for educational programs aimed at a range of health care providers that focus on the diagnostic evaluation of seniors presenting with seizures and principles of management. (Supported by a grant from the Centers for Disease Control and Prevention (Grant #U58/CCU322072). Its contents are solely the responsibility of the authors and do not necessarily represent the views of the CDC.)