Abstracts

Rationale: Intranasal (IN) midazolam and per rectum (PR) diazepam are both used to abort prolonged seizures or clusters of seizures in the home setting. Compared with PR diazepam, IN midazolam is easier for families to use, has fewer side effects, and is more cost-effective. The aim of this study is to determine if home use of IN midazolam impacts emergency department (ED) utilization and associated healthcare costs for seizure care compared to PR diazepam.Methods: In this retrospective study, we reviewed 5 years of data for 929 patients meeting the study’s inclusion criteria extracted from a database of an accountable care organization, Partners for Kids, which is responsible for the care of over 300,000 children in central and southeastern Ohio. Data elements that were included consisted of demographics, ED visits, as well as number of midazolam and diazepam prescriptions.Results: Use of IN midazolam was not associated with increased ED utilization or increased heathcare costs compared with use of PR diazepam. PR diazepam was associated with higher prescription costs.Conclusions: These findings support previous studies and show that both IN midazolam and PR diazepam are viable treatment options for patients at risk for prolonged seizure events.