Abstract Details

Title Beyond the Hospital Walls: Unpacking the Complexities of Acute ASM Initiation and Patient Follow-up

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-001

Objective

To explore the relationship between racial disparities and post-hospitalization follow-up in patients discharged on antiseizure medications (ASM) after continuous electroencephalography (cEEG).

Background The growing availability of in-patient EEG has led to increased diagnosis and treatment of acute symptomatic seizures (ASyS) and hyperexcitable EEG patterns. Prior studies indicate 50-90% of patients with ASyS or rhythmic and periodic patterns (RPPs), discharged on ASM, stay on them for 12-32 months. This often occurs without a clear need, promoting polypharmacy. Outpatient (OP) neurology evaluation is advised to determine the need for continuous ASM treatment.

Design/Methods Retrospective review of patients admitted to UF hospital between January 2020 and December 2022, without prior epilepsy, who required in-patient cEEG monitoring for over 24 hours. We investigated ASM prescription patterns at discharge and at OP follow-up with neurology, neurosurgery or neuro-oncology, within 1 year post hospitalization.

Results The cohort had 51 adult patients (25 females, 26 males). Eleven were Black, 39 were White, and 1 was identified as “Other.” While 67% were discharged on ASM and 24% were still refilling this medication at least a year later, only 44% of individuals had neurology follow-up within 6 months. Among those with follow-up, 83% were white and 13% blacks. In the group discharged with ASM, 63% of white patients had a follow-up at 1 year, as opposed to 38% of black patients. Only 1 patient in this group had seizure recurrence within 6 months.

Conclusions Our research indicates a prevailing tendency for physicians to prescribe ASM post-discharge, irrespective of assured post-hospitalization follow-up. This study highlights notable discrepancies in OP clinic attendance, with Whites having more consistent follow-ups than Blacks. Because of the risks of polypharmacy and unnecessary use of ASM, it is crucial to understand the factors limiting healthcare accessibility in vulnerable populations.

Authors/Disclosures
Lorena M. Figueredo Rivas, MD PRESENTER	Dr. Figueredo Rivas has nothing to disclose.
Leonid Gozman, MD (UFHealth)	Dr. Gozman has nothing to disclose.
Michael P. Siegel, MD	Dr. Siegel has nothing to disclose.
Steven Carter, Jr., DO	Dr. Carter has nothing to disclose.
Lindsey Le, DO (UF Health - Shands Hospital)	Dr. Le has nothing to disclose.
Maria J. Bruzzone, MD, FAAN (University of Florida)	Dr. Bruzzone has nothing to disclose.

��ɫ��

��ɫ��