Multidisciplinary Care May Help Reduce Disparities Associated with Race in Children and Adolescents with Psychogenic Nonepileptic Events
Abstract number :
2.308
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2021
Submission ID :
1826340
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Maggie Burch, MSW, LISW - Nationwide Children's Hospital; Sami Rossiter, MSW, LSW – Nationwide Children's Hospital; Katie McGinty-Kolbe, RN, MSN, FNP-C – Nationwide Children's Hospital; Megan Fredwall, MD – Nationwide Children's Hospital; Christy Tschirner – Nationwide Children's Hospital; Laurie Enciso, RN, BSN – Nationwide Children's Hospital; Jeannette Iskander, PhD – Nationwide Children's Hospital; Kristen Trott, PhD – Nationwide Children's Hospital; Kenneth Jackson, MS – The Ohio State University; Dara Albert, DO, Med – Nationwide Children's Hospital
Rationale: Psychogenic nonepileptic events (PNEE) are episodes consisting of motor or behavioral changes resembling epileptic seizures but are not caused by electrical dysfunction in the brain. Heath disparities based on race and socioeconomics have been documented in children with epilepsy and adults with PNEE; however, they have not been reported in youth with PNEE. We hypothesize that disparities exist in this population which impact overall care and therefore influence event remission.
Methods: We analyzed a retrospective database of youth referred to our multidisciplinary clinic from 2018-2020. All patient charts were screened by social work prior to the clinic visit to identify potential barriers to care and a nurse conducted follow-up calls. Patients’ race was identified from the Electronic Health Record and compared to several variables. Outcomes were collected via phone follow-up. Descriptive statistics were performed, and comparisons between white and non-white patients were completed using Fisher’s exact test and logistic regression.
Results: Two-hundred thirty-seven patients were identified as eligible to be considered during the study period. Sixty-eight patients (29%) identified as non-white. Only 64%, 57%, and 41% of the cohort were reached for follow-up at 1, 3, and 12 months, respectively. Outcomes were similar, but we found that non-white patients were more likely to have received support from social work due to identified barriers (p=0.045; Table 1).
Conclusions: Greater barriers to accessing care, as identified by social work screening, were identified in non-white patients compared to white patients referred to the clinic. This may imply healthcare disparities based on race, that without social work intervention may have led to worse outcomes for non-white patients. A multidisciplinary clinic that includes social work helps to mitigate barriers leading to more equitable care and similar outcomes for white and non-white youth with PNEE.
Funding: Please list any funding that was received in support of this abstract.: Funding support for statistical analysis was provided by Department of Neurology internal funds; There were no external funding sources for this project.
Behavior