Factors Influencing Transition Readiness in Epilepsy
Abstract number :
2.373
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2023
Submission ID :
1112
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Amanda Hornbach, MD – Cincinnati Children's Hospital Medical Center
Eugene Cho, BA – University of Cincinnati College of Medicine; Susan Fong, MD, PhD – Cincinnati Children's Hospital Medical Center; Paul Horn, PhD – Cincinnati Children's Hospital Medical Center
Rationale: The transition from pediatric to adult healthcare is an understudied process that has medical and psychosocial impact for patients with epilepsy. Little is known about factors that influence patient perception of "readiness" in transition. Here we aimed to identify clinical and social factors that influence perceived readiness for transition and explore if disparities exist between groups.
Methods: This was a retrospective cohort study of patients who received care at the Comprehensive Epilepsy Center at Cincinnati Children's Hospital between 10/1/21 and 12/31/22. 70 epilepsy patients aged 16 to 26 years who completed a transition readiness assessment (EpiTraq) at a clinic visit were included. Data extracted from electronic medical record review included demographics (i.e., age, sex, race, ethnicity, insurance status), epilepsy characteristics (i.e., age at diagnosis, epilepsy type, etiology, treatment history), medical/psychiatric comorbidities, and EpiTraq scores.
Results: Patients were majority female (63%), white (90%), not hispanic (100%), with private health insurance (77%), and taking zero to four anti-seizure medications (mean=1.4). Twenty-nine percent of patients had intractable epilepsy and 24% had advanced therapies (surgery, neuromodulation, dietary therapy). Age at diagnosis ranged one to 19 years (mean=12.0) and mean age was 18.7 years. Underlying etiology was unknown in most patients (77%), with highest identified cause being structural (20%). Patient age was positively correlated with perceived readiness for transition, as assessed by the total EpiTraq score (r=0.442,p< 0.001) as well as each subscale score (Figure 1). Older age at diagnosis was associated with higher scores in the Talk with Provider domain (r=0.287,p=0.017). No significant disparities were found based on sex, race, ethnicity, or insurance status. No significant association was found between perceived readiness and epilepsy type, etiology, length of diagnosis, or seizure frequency. Patients with previous resective surgery had significantly higher scores in the Talk with Provider (p< 0.001) and Managing Daily Activities (p=0.05) domains. The presence of cognitive impairment and medical comorbidities were associated with significantly lower scores (Table 1).
Health Services (Delivery of Care, Access to Care, Health Care Models)