Abstracts

Rationale: Epilepsy self-management (S-M) behaviors can assist people with epilepsy (PWE) yet availability of interventions to assess and improve S-M behaviors is limited. Hispanic PWE lack access to tailored S-M programs while also facing challenges in communicating with their English speaking healthcare providers (HCP). The Management Information and Decision Support Epilepsy Tool (MINDSET) is a tablet-based program (available in English and Spanish) designed to assist patients and providers to quickly assess, monitor, and develop a plan for improving epilepsy S-M during regular clinic visits. Frequency data on a patient’s S-M behaviors (in S-M domains of seizure, medication, and lifestyle) is assessed and behaviors are flagged if frequency is below ideal levels. The patient selects one ‘goal’ behavior for improvement (in each S-M domain) and the strategies to accomplish this. A printed Action Plan (English or Spanish) is reviewed by the patient and HCP and retained by the patient. The purpose of this study was to test the feasibility of using MINDSET during regular visits at neurology clinics. Methods: Hispanic patients (n=43) used MINDSET over two clinical visits at clinics in Arizona (n=2) and Texas (n=2) during 2016-17. Patients self-selected their language preference. After use, patients discussed their Action Plan with their neurologist and then completed usability/feasibility rating scales and an exit interview. At the end of the study, 3 of 4 participating neurologists provided interviews regarding feasibility. Results: Most patients (n=38) completed visit 2. Duration between visits was 172 ±43 days. Patients were mostly female (62.5%), 19 to 70 years (39.6±12.8), with mean age of diagnosis of 21.1±14.2 years. Most reported seizures in the last 12 months (87.5%) with more than one seizure per month (62.5%); had private insurance (62.5%) or Medicaid (12.5%); and selected the English version of MINDSET (63%). Across visits patients agreed that MINDSET was helpful (90%), understandable (93%), trustworthy (89%), promoted careful thinking about management (92%), was of appropriate duration (78%), and would be helpful in future management (86%) and future HCP communication (88%). Most patients thought MINDSET was easy to use (89%), helpful in selecting a behavior (92%) and strategies (86%) to work on. Most indicated they would use MINDSET again (86%) and recommend its use to others (86%). Neurologists agreed that MINDSET improved the ease, thoroughness, and accuracy to identify patient S-M problems and goals and to develop a patient S-M action plan and also improved communication with the patient (all ratings of 1 and 2 on a 5 point semantic differential scale). Neurologists recommended that HCPs adjust patient flow and allow for additional time if using MINDSET. Conclusions: The study indicates positive patient and neurologist usability and feasibility ratings for use of MINDSET in clinic visits while acknowledging additional time needs for patients to complete the program and discuss the Action Plan. Funding: Centers for Disease Control and Prevention