Telephonic review for outpatients with epilepsy-A prospective randomized, parallel group study

Area of Science:

• Neurology
• Epilepsy Management
• Healthcare Delivery Models

Background:

• Stable epilepsy patients require ongoing management to prevent seizures.
• Conventional face-to-face clinic visits can be time-consuming and costly.
• Alternative models of care are needed to improve access and efficiency.

Purpose of the Study:

• To compare the efficacy and efficiency of telephonic review versus conventional face-to-face clinic management for stable epilepsy outpatients.
• To assess differences in breakthrough seizures, cost, patient satisfaction, and follow-up rates.

Main Methods:

• A randomized parallel group study design was employed.
• Suitable patients from an Epilepsy Clinic were randomized to either telephonic review or conventional clinic visits.
• Primary outcomes included the percentage and number of breakthrough seizures; secondary outcomes included cost, patient satisfaction, and default rates.

Main Results:

• No significant difference in breakthrough seizures was observed between telephonic (FT) and face-to-face (FC) groups.
• Telephonic consultations averaged 10 minutes, compared to 22 minutes for face-to-face visits.
• The face-to-face group was more expensive (INR 865 average difference) and had significantly higher rates of patients lost to follow-up.
• Patient satisfaction exceeded 90% in the telephonic review group.

Conclusions:

• Telephonic review provides Class I evidence of non-inferiority to face-to-face management for stable epilepsy patients regarding breakthrough seizures.
• Clinicians should consider telephonic review for selected epilepsy patients to improve efficiency and potentially reduce the treatment gap.
• This approach can enhance access to care for patients with limited access to healthcare facilities.