Abstracts

Rationale: In 2007, we reported on the development of a self-management intervention in adults with epilepsy and findings of randomized pilot study [Pramuka M Epilepsy & Behavior 11 (2007) 533-545]. Despite efforts, recruitment was challenging and attrition was significant. We concluded that future directions may be better served by remote service delivery via the Internet or computer-based applications. Recognizing recent efforts to provide self-management interventions via the Internet, we gathered data on internet use and computer access in adults treated for epilepsy within the VA to determine the feasibility of extending computer-based interventions to the veteran population. Methods: Adult veterans seen in the VA Pittsburgh Healthcare System Neurology Clinic were asked to voluntarily complete an anonymous 18 item questionnaire over a seven month time interval. The first question asked was if the individual completing the questionnaire had ever been told be a doctor that they had epilepsy or seizures. The majority of the questionnaire gathered information regarding internet use, computer availability and interest in distance education regarding epilepsy. The final section addressed several demographic issues. No personal health information was collected. Results: 324 VAPHS Neurology clinic patients completed the survey. 126 self-reported a medical diagnosis of epilepsy, and will be referred to as the epilepsy/seizure group. The mean age was 54 +/- 18; there was no significant difference with respect to sex, age between those in the epilepsy group and those with other neurological diagnoses. In the seizure/epilepsy group, 65% (78) reported they traveled over two hours to be evaluated. There was not a significant difference between the seizure/epilepsy group and others who completed the questionnaire with respect to computer access or internet use and media access and use (Table 1). Less than half, 42%, of the epilepsy/seizure group answered affirmatively to the question "Would you be interested in getting information on epilepsy self-management provided on your computer?" In contrast over half, 56%, indicated that they would be interested in watching and learning about epilepsy self management on a video that they could use in a DVD or VHS player. When asked to rank their preferred method (DVD, Internet, VHS, or CD ROM) to learn more about epilepsy, the combination of first and second choices demonstrated the following preferential order: 1) DVD (n=63), 2) Internet (n=42), 3) VHS (n=28), 4) CD ROM (n=27). Conclusions: For this cohort of veterans with epilepsy, the need for remote/distance-based intervention was validated given the many veterans traveling long distances. However, DVD based materials would probably be more accessible than web-based interventions. If web-based interventions are applied to a veterans population, significant resources in providing internet access and training are likely to be required.