The purpose of this quality improvement project was to implement a structured seizure action plan (SAP) in an adult epilepsy center.  Specific aims include increasing provider SAP utilization rates, and assessing patient and/or care-partner knowledge and comfort scores associated with recognizing and managing seizure emergencies. Barriers and facilitators for utilization were identified.

While seizure action plans have been shown to be beneficial, they are not often utilized in adult clinical practice. Although current literature focuses on pediatric patients and providers, disseminating an easy-to-use, standardized SAP in an adult epilepsy clinic may provide an efficient, cost-effective education plan that can improve patients’ knowledge and comfort with seizure emergencies and be sustained in clinical practice.

A pre/post-implementation design was used. Five providers implemented the SAP during outpatient clinic visits. Pre and posttest knowledge and comfort was measured in patients 18 years or older with a confirmed history of epilepsy and/or their care-partners. Care-partners  were included if the patient was unable to read, write or comprehend English or per the patients request. Patients with non-epileptic events, patients new to the clinic, and those seen via telehealth were excluded from project participation.

The average provider SAP utilization rate was 51.45%. A total of 204 participants completed the pre and post-knowledge and comfort surveys. Results showed a significant increase in knowledge and comfort scores for seizure emergencies on all survey items, p<.001. At post survey analysis, 98% of participants felt that all patients with epilepsy should have a SAP regardless of seizure burden.

Implementing a structured SAP increased patient and care-partner knowledge and comfort of managing seizure emergencies. There was a clear disconnect between patient and healthcare provider counselling goals suggesting the importance of integrating SAPs into clinic visits. Identifying barriers and facilitators for utilization are key components to improve dissemination and SAP sustainability.