Abstracts

Rationale:
Epilepsy self-management skills may improve seizure control, quality of life (QoL), and medication adherence. A new, five-module educational book series, Exploring Epilepsy, was developed by UCB Inc., incorporating insights gleaned from epileptologists, pharmacists, patients, and caregivers, to empower patients to manage their epilepsy. This pilot project aims to assess feasibility of implementing this program in an ambulatory care clinic, and impact on patient clinical outcomes.
Method:
This single-center, prospective cohort study included patients (≥18 years) diagnosed with epilepsy, established at the William S. Middleton VA Epilepsy Clinic (Epilepsy Center of Excellence), and with functional capacity as confirmed by their healthcare provider. A study pharmacist scheduled and facilitated 5 telephone encounters (1-2 weeks apart) to discuss the content of the educational modules: Epilepsy 101, Medication Therapy Review, Disease Management Support, Medication Action Plan, and Follow-up Pharmacotherapy Consultation. Feasibility of implementation was measured by encounter completion time, patient completion rates, and proportion of patients requiring appointment rescheduling. Clinical outcomes included change from baseline to 3 months post-intervention in Epilepsy Self-Efficacy Scale (ESES), Epilepsy Self-Management Scale (ESMS), Patient Weighted QoL in Epilepsy (QOLIE-10-P), Generalized Anxiety Disorder-7 (GAD-7), and Neurological Disorders Depression Inventory in Epilepsy (NDDI-E). A patient satisfaction and perception survey was also completed 3 months post-intervention using a Likert scale.
Results:
A total of 20 patients were enrolled in the pilot program; 14 (70%) completed the five-module series. Most patients (55%) required rescheduling efforts for at least one appointment. Appointments lasted on average 25 (SD 9) minutes. Eight patients completed post-intervention assessments; all found the facilitator helpful (Table 1). Over 70% of patients noted the program improved their comfort in discussing epilepsy with others and their understanding of various self-management aspects for their chronic disease. There were no statistically significant differences in ESES, ESMS, QOLIE-10-P, GAD-7, or NDDI-E post-intervention (Table 2).
Conclusion:
Study findings support that implementation of Exploring Epilepsy is feasible in a clinic setting. Additionally, patients report high satisfaction with the service, and endorse enhanced understanding of various self-management strategies. While preliminary data did not show statistical improvements in various clinical questionnaires, as the sample size of this feasibility study is small and not powered to detect clinically significant differences, there are numerical improvements in the ESES and ESMS post-intervention responses. Future consideration for operationalizing this program includes leveraging the clinic scheduling team for administrative tasks or implementing the program in a patient group setting. Future directions include comparing implementation and outcome data at other sites.
Funding:
:UCB Pharma-sponsored