Abstracts

Rationale: Epilepsy is a costly neurological disorder, and there are numerous barriers to optimal epilepsy care. Per the Institute of Medicine (England, et al., 2012), the lack of medication adherence alone has been associated with increased hospitalization and emergency room (ER) costs of $1,799 and $260, respectively, per patient per year. The estimated healthcare costs experienced by epilepsy patients amounted to $9.6 billion in 2004. Our healthcare system is complex and expensive, and we may help drive down cost and improve healthcare quality starting with the proper use of ER service. Methods: New and follow-up adult outpatients with an established diagnosis of epilepsy were asked to fill out a questionnaire, identifying ER use related to epilepsy during the four months prior to visit. Patients with nonepileptic spells were excluded. Patients participated with or without a family member or caretaker. Each participant received handouts with educational materials, including general epilepsy care plan, antiepileptic drug side effects, drug-drug interactions, available transportation, medication assistance programs, common seizure triggers and their avoidance, seizure first aid, and when to call and not to call 911. An epileptologist briefly reviewed these educational materials with the participant. Each participant was also given the option to watch an Epilepsy Foundation DVD on seizure first aid after the clinic visit. Post-education assessment of ER use after four months was carried out with either a follow-up visit questionnaire or a telephone interview. Results: Ninety-three (93) patients participated. All received handouts and provided information on ER visits for the four months prior to receiving education. Of these, 51 (54.7%) also viewed the DVD. Information on ER visits for four months prior to receiving education was obtained from all 93 patients. Information on ER visits during the four months following education was obtained from 90 of the 93 (96.8%). There was a significant decline in the number of patients who visited the ER before education (22/93 or 23.7%) versus after education (1/90 or 1.1%, p=0.0026*). The decrease in ER visits that follows education is similar, regardless of whether the patient, family member, or caretaker viewed the DVD. ER visitation declined following education among those who received only the handout, and also among those who also viewed the DVD. The decline in ER visitation did not differ significantly between the two groups. Conclusions: Providing clinic patients with educational materials on epilepsy care, seizure first aid, and proper ER use is correlated with significant decrease in ER use among patients with epilepsy. This finding supports patient education as a valuable tool to reduce ER use, which may in turn cut down on healthcare cost.