Health care transition outcomes in epilepsy: A sample transfer clinic

Adolescents and young adults (AYAs) with epilepsy often require disease-specific care into adulthood. This study describes a sample of AYAs with epilepsy receiving adult neurologic care and examines transfer time and health care utilization for those who did and did not use our Epilepsy Transition Clinic (ETC).

Data for AYAs participating in an ETC were compared to peers not participating in the clinic. Between-group comparisons and regression analyses examined differences by clinic group and time point (i.e., pre- versus post-transfer to adult neurologic care) in health care utilization and time to transfer with age at transfer, sex, medical and psychiatric comorbidities, insurance, time since diagnosis, seizure frequency, and history of advanced treatments as covariates.

This single-center retrospective review identified 89 adult patients, 40 of whom utilized a formal transition clinic. Significant group differences were identified in time to transfer (t = 2.64, p = 0.01), seizure frequency (χ2 = 9.46, p = 0.05), and presence of pediatric medically-refractory epilepsy (χ2 = 4.467, p = 0.04). Transfer time for those using the ETC was shorter than for those not using it (b = -0.39, p = 0.01). There was a significant difference obtaining vitamin D levels (OR = 10.42, p = 0.001), with those in the transition clinic more likely to have levels checked compared to those not in the clinic.

ETCs may reduce transfer time, facilitate medical engagement between phases of neurologic care, and increase monitoring for epilepsy-specific comorbidities.