Abstract Details

Title Epilepsy: Transition from Pediatric to Adult Care. Recommendations of the Ontario Epilepsy Implementation Task Force

Topic Practice, Policy, and Ethics

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-067

Objective Recently, the Ministry of Health and Long Term Care of the Province of Ontario, Canada created a Transition working group (TWG) to develop recommendations for the transition process for patients in the Province of Ontario. Here we present an executive summary of this work.

Background Transition from pediatric to adult health care system is challenging for most youth with epilepsy and their families.

Design/Methods The TWG was composed of pediatric and adult epileptologists, psychiatrists and family doctors from academia and from the community; pediatric and adult neurologists from the community; neuropsychologists; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability, and project managers. There were 4 main areas addressed: 1) Diagnosis and Management of Seizures 2) Mental Health and Psychosocial Needs 3) Financial, Community and Legal Supports and 4) Screening tools.

Results Although there are no systematic studies on the outcomes of transition programs, the TWG’s impressions are as follows. Teenagers at risk of poor transition should be identified early. The care coordination between pediatric and adult neurologists and other specialists should begin before the actual transfer. The transition period is also the ideal time to rethink the diagnosis and repeat diagnostic testing where indicated (particularly genetic testing, which now can uncover more etiologies than when patients were initially evaluated many years ago). Some screening tests should be repeated after the move to the adult system.

Conclusions The 7 steps proposed here may facilitate transition, thus promoting uninterrupted and adequate care for youth patients with epilepsy leaving the pediatric system.

Authors/Disclosures
Danielle M. Andrade, MD (University of Toronto) PRESENTER	The institution of Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceutical. The institution of Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke Therapeutics. The institution of Dr. Andrade has received research support from Epilepsy Canada. The institution of Dr. Andrade has received research support from SynGAP Research Fund. Dr. Andrade has received publishing royalties from a publication relating to health care. Dr. Andrade has a non-compensated relationship as a Former Chair of task force on Transition with International League Against Epilepsy that is relevant to AAN interests or activities. Dr. Andrade has a non-compensated relationship as a President with Canadian League Against Epilepsy that is relevant to AAN interests or activities.
	No disclosure on file
Eduard Bercovici, MD (Eduard Bercovici Medicine Professional Corporation)	No disclosure on file
Felippe Borlot, MD (University of Manitoba)	Dr. Borlot has nothing to disclose.
Esther Bui, MD (Toronto Western Hospital)	Dr. Bui has received publishing royalties from a publication relating to health care.
Peter R. Camfield, MD	No disclosure on file
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Ayman E. Hassan, MD, FAAN (Thunder Bay Regional Health Science Centre)	Dr. Hassan has nothing to disclose.
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Berge A. Minassian, MD (Univeristy of Texas Southwestern Medical Center)	Dr. Minassian has nothing to disclose.
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Michelle Shapiro, MD	Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pendopharm. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB.
Marie Slegr, MD	No disclosure on file
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Sharon E. Whiting, MBBS, FR	Dr. Whiting has nothing to disclose.
O. C. Snead III, MD, FAAN (Hospital for Sick Children)	Dr. Snead has nothing to disclose.

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