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Published on: April 11, 2019
Assessing multilevel provider knowledge and confidence in identifying and addressing gaps in epilepsy care
Elaine T Kiriakopoulos1, Alexis Griffith2, Anne Gramiak2
1Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Rd, Hanover, NH 03755, USA; Department of Neurology, Dartmouth Health, 1 Medical Center Drive, Lebanon, NH 03756, USA; The Dartmouth Institute for Health Policy and Clinical Practice, 1 Medical Center Drive, Lebanon, NH 03756, USA.
Rationale:
People with epilepsy (PWE) face many disparities in healthcare. Standardized epilepsy self-management (ESM) programs have demonstrated benefits in health outcomes and quality of life for PWE. However, ESM practices and behaviors are less commonly implemented among PWE from underserved populations. This project aims to identify gaps in knowledge and confidence surrounding epilepsy care inclusive of ESM that exist among epilepsy specialist clinicians (ESC) and non-specialist clinicians (NSC).
Methods:
Two surveys were designed, one for ESC and one for NSC, to identify respondents' perceived level of knowledge and confidence in practice about ESM, stigma, treatment and seizure first aid as well as the respondents' self-rating of their knowledge and awareness of social determinants of health (SDOH) affecting epilepsy care. Face and content validity were established, and surveys were delivered electronically. Data analysis was descriptive.
Results:
276 responses were analyzed. Strong correlation between knowledge and confidence was observed for both ESC (r = 0.91) and NSC (r = 0.89) across all epilepsy care domains surveyed. ESC subgroup analysis demonstrated a significant difference between epileptologists and neurologists (p < 0.0004) regarding knowledge for counseling patients on ESM skills (p < 0.002), knowledge of available ESM programs, (p < 0.02) and referral to ESM (p < 0.001). Significant differences were observed between ESC and NSC regarding counseling patients on ESM skills (p < 0.0001), knowledge of available of ESM programs (p < 0.0006), and referral to ESM programs (<0.008).
Conclusions:
Professional education addressing the needs of both ESC and NSC is necessary for improvements in health outcomes and quality of life for PWE.
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