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Abstract Details

Beliefs About Anti-seizure Medications in Seizure-free Adults with Epilepsy
Epilepsy/Clinical Neurophysiology (EEG)
P8 - Poster Session 8 (5:30 PM-6:30 PM)
Little is known about patients’ or their caregivers’ views about ASM tapering after a period of seizure control.
To explore patient and caregiver views about tapering antiseizure medications (ASM) and perceptions of medication effectiveness.
We conducted in-person or virtual semi-structured interviews including survey questions with 15 adults with epilepsy (or their caregivers) who were seizure-free >1 year and followed by neurologists at an urban academic institution.

Of 15 subjects, 9 (60%) were female, 14 (93%) were African American, and the median age was 46 years (interquartile range [IQR] 36-61). Six (40%) subjects took >1 ASM, and two (13%) took no ASMs. Median seizure-free duration was 2.3 years (IQR 1.5-3.9). Three (20%) interviewees answered for a family member with cognitive impairment.

From 1 (“Strongly disagree”) to 7 (“Strongly agree”), the median was 5 (IQR 4-7) regarding whether interviewees would consider tapering ≥1 ASM if their doctor recommended it. When asked how effective their ASM is from 0 (“doing nothing”) to 10 (“guaranteeing seizure-freedom”), median response was 9 (IQR 8-10). When asked how effective an ASM needed to be to continue taking it, median response was 8 (IQR 6-10). On a subsequent question, 12 (80%) indicated any type of seizure reduction (frequency or severity) would make an ASM worth taking. From 1 (“Not at all bothersome”) to 7 (“Very bothersome”) regarding taking ASMs, median response was 3 (IQR 1-6); one (6.7%) felt ASMs were doing more harm than good.

Interviewees perceive ASMs to have high efficacy and relatively low burden. While interviewees often indicated they would continue ASMs only if almost perfectly effective, further probing suggested even small reductions in seizure likelihood or severity would be sufficient for many. Future efforts should investigate specific factors influencing these perceptions and their impact on patients’ willingness to taper ASMs.
Max Kuster
Mr. Kuster has nothing to disclose.
Jordan M. Silva Mr. Silva has nothing to disclose.
Kara Manuel No disclosure on file
Palak S. Patel, MD (JFK Neuroscience Institute, Hackensack University Health) Dr. Patel has nothing to disclose.
Marla Reid (SUNY Downstate Health Sciences Center) No disclosure on file
Katherine Mortati, MD (State University of NY Downstate) Dr. Mortati has nothing to disclose.
Arthur C. Grant, MD, HD (SUNY Downstate Health Sciences University) The institution of Dr. Grant has received research support from Marinus.
Chloe E. Hill, MD (University of Michigan) The institution of Dr. Hill has received research support from NIH. The institution of Dr. Hill has received research support from AAN. The institution of Dr. Hill has received research support from NIH. Dr. Hill has a non-compensated relationship as a member of AAN Health Services Research Subcommittee with AAN that is relevant to AAN interests or activities.
James F. Burke, MD (Ohio State Wexner Medical Center) Dr. Burke has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association/Circulation: Cardiovascular quality and outcomes.
Samuel W. Terman, MD (University of Michigan, Neurology Dept) Dr. Terman has received research support from American Epilepsy Society. Dr. Terman has received research support from Epilepsy Study Consortium. Dr. Terman has received research support from New York University. Dr. Terman has received personal compensation in the range of $100,000-$499,999 for serving as a clinician scientist trainee for Susan S Spencer award with American Academy of Neurology.
Susanna O'Kula, MD Dr. O'Kula has nothing to disclose.