Abstracts

Rationale: Epilepsy self-management (SM) among Hispanic people with epilepsy (PWE) may be improved with increased awareness of SM strategies and targeted communication between patients and healthcare providers (HCP). SM helps PWE increase self-confidence and better cope with their disease.  Despite advances, educational SM interventions for PWE are still limited. The Management Information and Decision Support Epilepsy Tool (MINDSET) is a tablet-based program (English and Spanish) designed to assist patients and HCP to develop an epilepsy SM plan and monitor progress during clinic visits.  Patients respond to MINDSET at the clinic and their SM behaviors related to seizure, medication, and lifestyle management that need improvement are identified. For each SM domain, if applicable, patients are asked to select one ‘goal’ behavior, strategies to improve that behavior, and their confidence in achieving that goal. During the clinic encounter, the patient and HCP review the Action Plan (English or Spanish) together. The purpose of this longitudinal studyis to test the efficacy of using MINDSET over three clinic encounters. MINDSET was tested previously and improvements made for this study were guided by patient and HCP feedback. Methods: Four clinics, 2 in Texas (through the Epilepsy Foundation Central & South Texas) and 2 in Arizona (Banner University Medical Center), recruited eligible patients who were randomly assigned to the treatment or control group. Both groups provided demographic information and completed the first part of MINDSET (an adapted version of the DiIorio Epilepsy SM Scale). The treatment group also selected goals and strategies, and received a printed Action Plan to discuss with their HCP. Patients in the control group did not receive feedback regarding SM behaviors that could be improved, were not asked to select goals and strategies, and did not receive an Action Plan. Instead, they continued with their regular clinic. These actions will be repeated for the 2^nd and 3^rd clinic visits. Results: A total of 94 Hispanic patients (41 in TX, 53 in AZ) were recruited, with 48 randomly assigned to treatment and 46 to control. Both groups were relatively similar demographically (slightly more females among controls 56% vs 50%) although the treatment group had slightly more years of education.  Almost half (45%) of patients have had a seizure in the past 30 days although 65% indicated that in general their health was good or better. Asked about treatment decision-making, half of the patients either wanted equal responsibility or for the HCP to consider the patient’s opinion.  Results regarding patients’ SM behaviors, selected goals and strategies, and behavior changes between the 1^st and 2^nd visit will be reported at the meeting.  To date, anecdotal reports suggest that HCPs find that MINDSET prompts patients to discuss topics with them and that patients appreciate learning about seizure triggers and likely medication side effects. Conclusions: Clinic experience suggests that MINDSET is improving communication and expanding patient awareness of SM strategies and epilepsy-related information that may affect their epilepsy SM. Funding: None