Abstracts

Rationale: The Management Information & Decision Support Epilepsy Tool ("MINDSET") is a tablet-based decision support system designed to identify patient epilepsy self-management needs, provide behavioral goals, and facilitate communication between the patient and health care provider (HCP) during a regular clinic visit. The purpose of this study was to evaluate the feasibility of MINDSET for clinical use. Methods: A single group pre-post feasibility study was conducted during the clinic visits of adult patients at three participating neurology specialty clinics (n=38). Patients interacted with MINDSET prior to and during their encounter with their HCP. Patients entered seizure, medication, and management data, then reviewed their management profile with prompts of suggested discussion points on self-management issues and needs, and then presented the tablet to their HCP. The provider and patient could choose to refer to the tablet during the encounter. Underlying behavioral theories informing MINDSET include Social Cognitive Theory, self-regulation theory, motivational enhancement strategies, and the 5A Model (Ask, Assess, Advise, Assist, Arrange). Hypotheses relating to feasibility, usability, perceived impact, correspondence and communication were investigated using written survey and interview data collection methods. Results: Feasibility: Time required for patients to complete their profiles in MINDSET took an average of 28 minutes (range: 12-67 min.). Patient ratings of time on task were favorable (88%) and MINDSET was perceived as minimally disruptive to clinic visits by patients and providers. Usability and perceived impact: Patients rated MINDSET favorably on usability parameters of helpfulness (85%), likeability (91%), understandability (91%), and motivational appeal (85%). Patients perceived MINDSET as having a positive impact on thinking about and managing their epilepsy (79%) and communicating with their HCP (79%). Correspondence and communication: Correspondence existed between self-management issues flagged in MINDSET and the patient-HCP discussion. The quality of communication when using MINDSET was rated positively, particularly for nonverbal attention, reinforcement, and reflective listening. Providers were positive about MINDSET indicating they would recommend it to other providers and would continue to use it in their clinic if given the opportunity. Conclusions: Initial analysis of the results from patients and providers at three epilepsy clinics indicate that MINDSET is useful for discussing self-management issues, identifying needs, and developing an action plan as part of a clinic visit.