Examining Seizure Documentation Practices by Primary Care Clinicians.

Area of Science:

• Neurology
• Primary Care Medicine
• Health Services Research

Background:

• Primary care clinicians (PCCs) report low comfort managing seizure disorders.
• PCCs play a crucial role in caring for patients with seizures, including those from systematically excluded groups.
• This study examines seizure care practices and documentation in primary care settings.

Purpose of the Study:

• To explore seizure care practices among PCCs at a federally qualified health center.
• To examine associations between provider documentation of seizure care and proxy indicators for seizure disorder control.

Main Methods:

• Retrospective observational cohort study of patients with seizure disorders (2015-2019).
• Logistic regression models analyzed associations between patient demographics, clinical processes, outcomes, and electronic medical record documentation.

Main Results:

• PCCs met quality metrics for documentation in 41.5% of 446 cases.
• Seizure type was documented in 94.3%, but seizure frequency/time since last seizure in only 44.3%.
• Better clinical documentation correlated with neurologist referral (OR 1.73), neurologist visits (OR 1.7), and mental health/QoL screenings (OR 2.97).

Conclusions:

• Improvements are needed in documenting seizure management within primary care.
• PCCs may require additional training or tools to enhance seizure treatment comfort and understanding of their role.
• Enhanced documentation practices are associated with improved patient care pathways.