Abstracts

Rationale: Currently, there are over 20 medications used for the treatment of epilepsy, each with specific side effect profiles. The American Academy of Neurology (AAN) has recently set forth quality measures to improve delivery of care to epilepsy patients. Measure 5 recommends the query and discussion of antiepileptic drug (AED) side effects at each visit and subsequent documentation of this practice. Methods: Twenty nine neurology residents at the Detroit Medical Center (DMC) were asked to complete a 19 item anonymous questionnaire about their knowledge of AED side effects and their screening practices. Questionnaire assessed knowledge of both old and new generation AED side effects and results of such were compared. Resident clinic charts were then reviewed to assess actual screening practices. Results: Seventeen questionnaires were completed (59%). Seventy one percent of residents knew that AAN Quality Measures recommend screening for AED side effects at every visit, yet only 6% reported screening at every visit. Eighty two percent of residents felt that knowledge was their biggest barrier. Knowledge of new generation AED side effects was better than knowledge of old generation AED side effects. Neurology resident clinic charts over a 6 month period were then reviewed. Sixty charts had the chief complaint of seizures or epilepsy, 48 of which the patient was on an AED. Screening for side effects was done 44% of the time. Conclusions: We concluded that an educational gap in neurology resident knowledge of AED side effects exists, particularly for old generation AEDs; possibly contributing to low screening practices. Self-reported screening practices of AED side effects amongst neurology residents were exceedingly low and actual screening practices were suboptimal. Further interventions are needed in the form of educational modules and/or patient screening forms used in clinic to improve adherence to epilepsy quality Measure 5.