Abstract Details

Title Therapeutic Utility of Long-Term Monitoring Diagnosis in Psychogenic Nonepileptic Events (PNEE) on Patient Illness Perception and Hospital Resource Utilization

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S08 - (-)

Poster/Presentation
Number 004

Objective

Background LTM is considered the gold standard in the diagnosis of PNEE, resulting in diagnostic changes and altering clinical management in 24-71% of referrals made to tertiary referral. The average delay in diagnosis of PNEE approaches 7 years, during which time these patients receive unnecessary workup and treatment including ER and outpatient visits (O), inpatient and ICU admissions (I), and antiepileptic drugs (A), all with associated costs and morbidities (5).

Design/Methods A sequential list of 65 patients admitted for LTM to the VAMC from 2009 to 2012 was used for review of all encounters. All O, I, and A up to 7 years prior to and 1 year following definitive LTM diagnoses of PNEE were quantitatively and qualitatively analyzed to determine how resource utilization changed and how diagnosis affected patients' illness experience and productivity. All analyses were performed in Matlab.

Results There was a trend toward fewer outpatient visits related to PNEE as well as various other diagnoses following LTM. There were far fewer inpatient visits and no ICU admissions for PNEE either before or after LTM. AED use also declined after diagnosis. PNEE frequency and intensity, productivity, did not change as readily per patient questionnaires, yet disatisfaction with PNEE diagnosis was not instantiated through search for a second opinion or development of new unexplained symptoms.

Conclusions Despite variable improvement of PNEE frequency and intensity, and self-reported productivity, the patients do appear to utilize health-care resources less.

Authors/Disclosures
Karen Nunez-Wallace, MD (Optum Care) PRESENTER	No disclosure on file
Dona K. Murphey, MD	Dr. Murphey has received personal compensation for serving as an employee of CortiCare.
David K. Chen, MD (Baylor College of Medicine)	No disclosure on file
Christina Caon, RN, BS (38 North Street)	Ms. Caon has received personal compensation for serving as an employee of EMD Serono.
Anne-Marie Trudelle, MD	Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Trudelle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme.

��ɫ��

��ɫ��