Abstracts

Rationale: Prior studies suggest that up to a third of patients with uncontrolled seizures continue to drive despite medical restrictions. Motor vehicle morbidity and mortality has occurred secondary to accidents caused by patients with intractable epilepsy (PWE). Many studies have identified variables that correlate with driving and epilepsy: Age, employment status, and fewer AEDs predict the likelihood of driving with uncontrolled seizures. Although this is helpful, there are no studies assessing perceived risk associated with driving in this population. In addition, there are limited data exploring perceptions of transportation resources for PWE. The purpose of this study is to assess health behavior concepts related to driving in PWE. This study also explores perceived availability of transportation resources. Methods: This is an exploratory, cross-sectional study design. Persons with epilepsy were invited to complete a three page, 46-item questionnaire emphasizing demographics and health behavior concepts. Participants were identified through mailing list, EFA WEB sites and an outpatient clinic. To maintain confidentiality, identification data were not collected. Results: Ninety-four patients completed the survey. There were no significant differences between gender, age and income for 6 health behavior scales: concern, attitudes, severity/susceptibility, barriers, social support and self-efficacy. Non-Caucasians reported higher levels of general health concern than Caucasians (F=6.20, p=.015). Eighteen percent of patients were not completely honest with their doctor when disclosing seizure control due to the desire to drive. Persons not honest about seizure frequency had a higher level of perceived barriers for changing driving behavior (F=4.29, p=.042). Fifty-three percent were unaware of state driving laws. Although 98% were aware that having a seizure while driving could cause injury or death, only 20% reported being counseled about the risk. Forty-two percent felt that drivers were best qualified to judge their ability to drive. While 67% agreed that family members would support changes related to driving, 43% did not want to ask family/friends to assist with transportation. Forty-one percent felt that changing driving behavior was not possible because family/friends were unavailable. Thirteen percent believed that since 'things just happen', one should not be concerned with accident prevention. Forty-four percent believed that changing driving patterns was not possible due to a lack of transportation resources.Conclusions: While current interventions focus on disclosure and injury associated with driving and uncontrolled seizures, this study supports the need to also address perceived barriers when counseling PWE. To minimize at risk behavior, counseling interventions and outreach programs should also focus on increasing awareness of current resources and enhancing transportation options for PWE.