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. 2016 Mar;31(4):433-8.
doi: 10.1177/0883073815597755. Epub 2015 Aug 5.

Seizure Action Plans Do Not Reduce Health Care Utilization in Pediatric Epilepsy Patients

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Free PMC article

Seizure Action Plans Do Not Reduce Health Care Utilization in Pediatric Epilepsy Patients

Lindsi M Roundy et al. J Child Neurol. .
Free PMC article

Abstract

Management of pediatric epilepsy requires complex coordination of care. We hypothesized that an improved seizure management care plan would reduce health care utilization and improve outcomes. The authors conducted a cohort study with historical controls of 120 epilepsy patients before and after implementation of a "Seizure Action Plan." The authors evaluated for differences in health care utilization including emergency department visits, hospitalizations, clinic visits, telephone calls, and the percentage of emergency department visits that resulted in hospitalization in patients who did or did not have a Seizure Action Plan. The authors found that there was no decrease in these measures of health care utilization, and in fact the number of follow-up clinic visits was increased in the group with Seizure Action Plans (4.2 vs 3.3, P = .006). However, the study was underpowered to detect smaller differences. This study suggests that pediatric epilepsy quality improvement measures may require alternative approaches to reduce health care utilization and improve outcomes.

Keywords: epilepsy; hospitalizations; quality improvement.

Conflict of interest statement

Conflicts of Interest

The authors state that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
A sample Seizure Action Plan to be provided to a patient/family upon discharge from the hospital.
FIGURE 2
FIGURE 2
Number of ED visits, hospital admissions, neurology clinic follow-up visits and telephone messages (“message logs”) before (No SAP) and after (SAP) implementation of a Seizure Action Plan, each group compared over 18 months. There were no statistically significant differences in outcomes between the groups. Box plots (25th and 75th percentiles); center line, median; whiskers, 1.5 interquartile range.
FIGURE 3
FIGURE 3
Percentage of ED visits that result in hospital admission before (No SAP) and after (SAP) implementation of a Seizure Action Plan. There was no statistical difference between the groups, p= 0.99. Error bars, binomial proportion confidence interval (95% confidence interval).

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