Abstracts

Rationale: The aim of this study was to analyze the influence of a seizure action plan (SAP) on caregiver knowledge and school involvement. We also evaluated seizure rescue medication use and prescription patterns in a pediatric population. Methods: Cross-sectional observational study based on surveys to caregivers of patients with epilepsy and medical chart review. We analyzed the outcomes using the Fisher exact test. Results: One hundred (92.6%) out of 114 caregivers answered the survey. Fifty-five (55%) patients were female, with a mean (p25-p75) age of 11 (6-14) years. Of those surveyed, forty-five (45%) reported having a SAP, while 55 (55%) answered that they did not have a SAP in place. Forty-two (95.5%) families with a SAP knew the name of their child’s rescue medication, compared to 33 (80.5%) families without a SAP (p=0.04). Thirty-five (79.5%) families with a SAP knew the correct timing of the rescue medication administration, versus the 20 (48.8%) families without a SAP (p=0.004). Families with a SAP more often answered that they would take action – either call 911, their neurologist or go to the ER – if the rescue medication did not work, as compared to families with no SAP (31 (68.9%) vs 20 (40.8%); p=0.008) (Figure 1.).Additionally, 42 (97.7%) families with a SAP reported that schools were aware of the rescue medication, versus 25 (56.8%) families without a SAP (p < 0.001). Thirty-eight (88.4%) families with a SAP reported that the school had accessibility to the rescue medication, compared to 28 (66.7%) of families without a SAP (p=0.02) (Figure 1.).Eighty-seven (87%) patients had a rescue medication prescribed, with the most common rescue medication being rectal Diazepam (79 (90.8%)). Other rescue medications were Midazolam (6(6.9%)), Clonazepam (1(1.2%)) and Lorazepam (1(1.2%)) (Table 1). Most prescriptions indicated administering the medication after 3 or 5 minutes of seizure activity (77(88.5%)) (Table 1). The rescue medication dose indicated during the most recent visit was in a recommended weight-based range in 35 (40.7%) patients, low in 44 (51.2%) patients and high in 7 (8.14%) patients according to routinely accepted benzodiazepine dosing. Conclusions: Families with a SAP were more knowledgeable about their child’s rescue medication and their schools were more involved. In addition, half of the rescue medication prescriptions were under dosed. Interventions are in progress to improve rescue medication application, timing and dosing. Funding: Epilepsy Research Fund