Abstracts

Rationale: A recent study identified the need for better patient education to improve epilepsy pediatric care and reduce health-care system costs (J Child Neurol. 2018 33;193-197). However, few studies have investigated the educational needs and the challenges faced by physicians with epileptic pediatric patients. The objective of this needs assessment is to identify areas of improvement in pediatric epilepsy care that could be addressed through medical education activities. Methods: The educational needs assessment was deployed in two consecutives phases and included neurologists, pediatricians, neuropediatricians and nurses in Germany, Spain and US, all having pediatric patients with epilepsy. Respondents were requested to self-report if they had a competency in epilepsy or not. Phase 1 consisted of semi-structured interviews aiming to explore challenges spontaneously expressed by participants. Qualitative data were analysed using thematic analysis (NVivo). The emerging themes were used to design the phase 2 survey, which aimed to quantify the challenges among a larger sample. Quantitative data were analysed using cross-tabulations and chi-square tests (SPSS). All data collected were then triangulated. Final findings were interpreted collaboratively by clinical and educational experts. Results: The needs assessment included 267 participants (Germany=73, Spain=74, US=120). Qualitative data obtained from semi-structured interviews  (phase 1) were collected among 22 neurologists, 44 neuropediatricians and 22 nurses. Quantitative data were obtained from 56 neurologists, 62 pediatricians and 61 neuropediatricians. Three of the identified challenges will be presented hereby, in the (1) treatment, (2) management and (3) communication areas. Firstly, lack of knowledge and skills were reported by participants towards treatment and their utilisation. On average, 61% of participants reported sub-optimal knowledge of safety profile of newest generation antiepileptic drugs. Knowledge gap was higher among participants without vs. with a competency in epilepsy (74% vs. 55%, p <0.005). Secondly, intellectual or developmental disability and ADD/ADHD where both selected among the top 3 most challenging comorbidities to manage by 47% of respondents, among a list of 11 comorbidities. Thirdly, sub-optimal skills communicating interprofessionally, and with patients/caregivers, were reported. A third of participants reported sub-optimal skills determining treatment goals and objectives with their teenage patients and 36% of participants reported rarely communicating with other specialists involved in the care of their pediatric patients with epilepsy. Conclusions: This study led to the identification of clinical and communicational challenges in pediatric epilepsy care.These data can be used to inform future learning activities that are evidence-based and target the needs of specialist physicians having pediatric patients with epilepsy. These areas could also be used as a starting point of local needs assessments for greater impact on patient care. Funding: This work was supported by education grants from UCB.