Abstract Details

Title Quality of Epilepsy Care in Medicaid-only Neurology Resident Clinic

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-029

Objective The aim of this study is to investigate if epilepsy care in a general neurology, Medicaid-only, resident clinic is in concordance with the 2014 and 2018 AAN guidelines.

Background The ��ɫ�� (AAN) published epilepsy quality measures in 2009 with updates in 2014 and 2018.

Design/Methods A chart review was performed from a single academic center using the hospital’s Clinical Data Warehouse. Patient charts were reviewed within the neurology resident clinic for visits between April and September 2017 with epilepsy-related ICD10 codes. Demographic data and data relevant to the AAN guidelines was reviewed.

Results One hundred eighty seven clinic visits were identified; 169 were confirmed for initial seizure or epilepsy and 17 were for other reasons. Mean age was 51 years, and 98 were women. Ninety-six percent documented seizure frequency, 95% documented seizure intervention, 86% documented seizure type/etiology, 47% documented medication side effects, 15% screened for psychiatric co-morbidity, 13% documented discussion of safety and education and 5% were referred to our Comprehensive Epilepsy Center (CEC). No note documented Quality of Life Assessment and Outcomes. There were 37 women between 12-44 years old. The notes for 7(19%) of these patients documented education on teratogenicity or risks of epilepsy and pregnancy. Nineteen patients required multiple antiepileptics of which two (10%) were referred to the CEC.

Conclusions In this neurology resident clinic, the measures with which the physicians’ notes were more concordant with AAN epilepsy quality measure guidelines are topics that are often also addressed in the acute care setting. This might reflect a greater comfort level among residents with acute management of neurological issues as opposed to chronic care. Though this study reflects the experience in one neurology residency program, many programs are faced with the challenge of ensuring adequate education in ambulatory neurology topics. These results can guide educational programming for neurology residents.

Authors/Disclosures
Genna Waldman, MD (University of Pennyslvania) PRESENTER	Dr. Waldman has nothing to disclose.
Michelle Bell, MD (New York Presbyterian Hospital, Columbia)	Dr. Bell has nothing to disclose.

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