Abstracts

Rationale: Epilepsy treatment is not always easy. Finding a combination of Anti epileptic drugs (AED) that will control seizures with no or minimal side effects often require several adjustments. Because it is difficult to obtain an appointment with the physician on short notice, epilepsy hotlines generally receive many calls. The objective of this study was to analyse phone calls received at our epilepsy clinic hotline and determine the patients profiles and principal motives.Methods: We undertook a retrospective study of phone calls received between January 1st 2004 and June 4th 2011. Calls were destined to a single epileptologist (DKN) initially and to two (DKN, PC) from June 2010. When available, we determined the patient and caller s identity, demographic region, age, call date, call time and motive. Call motives were classified into 7 categories: seizures notifications, report of side effects, general questions related to epilepsy or epilepsy surgery, questions related to AED (other than to report side effects), medical forms, appointments or tests, and miscellaneous. Results: Between January 1st 2004 and June 4th 2011, we received 5189 calls. The mean age was 39yo (n= 991 patients), 32% being between 20-30yo and 22% between 40-50yo. The majority of calls were made by patients themselves (2664/3704; 72%), followed by family members (576/3704; 16%), health care providers (419/3704; 11%) and others (45/3704; 1%). The busiest calling time window was between 10:00 to 12:00. Calls came from 17 demographic areas, mostly from the Montreal Island (2145/4400; 49%), Monteregie (761/4400; 17%) and Laurentides (403/4400; 9%) regions. The majority of calls were related to AED (973/3904; 25%) and seizures notifications (891/3904; 23%), followed by questions about appointments or tests (483/3904; 12%), report of side effects (376/3904; 9%), medical forms (299/3904; 8%) and general questions related to epilepsy or epilepsy surgery (118/3904; 3%). While patients and health care providers primarily called for questions related to AED (440/2000; 22% and 166/282; 59%, respectively), family members primarily called for seizures notifications (112/414; 27%). Almost half the workload (2375/5189; 46%) was generated by 10% of patients (117/1232) with a frequency of 11 to 89 calls during this 89 months period. Conclusions: Based on the number of calls received, the epilepsy clinic hotline is a service which obviously responds to a need from patients and family members. The majority of calls had a motive requiring a rapid intervention (i.e. related to seizures or medication). The important number of calls from outside the city reflects the tertiary nature of our clinic but also the lack of resources in rural regions. Finally, developing a novel approach to better address the needs of the small percentage of patients generating close to half the workload of the epilepsy clinic hotline is desirable whether it be from nurse or social worker home visits, tutorials for patients or family members or involvement of support groups.