For 2.7 million Americans with epilepsy, seizures are not the only concern. People with epilepsy frequently face mood and behavior challenges and side effects from their medications, such as sleep and cognition problems. And, in many instances, these issues are not getting the attention warranted during visits with neurologists, according to a study supported by Ortho-McNeil Neurologics(R), Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Today at the American Academy of Neurology Annual Meeting in Seattle, new insights from an in-office linguistic study of neurologists identified gaps in communication between physicians and their epilepsy patients. These findings revealed the need for more thorough conversations about mood and behavior issues and side effects of epilepsy medications between neurologists and their patients.
In this study, office visits were audio- and video-recorded. Both patients and physicians were asked about what they discussed following their appointments. The study found that, in most visits, topics related to mood and behavior were not discussed. Additionally, in one out of four visits, neurologists did not assess side effects of antiepileptic drugs (AEDs).
“The findings are important to note because epilepsy often involves complex treatment issues that extend beyond seizure control,” said Frank Gilliam, MD, study author and Director of Neurology at Geisinger Health System in Pennsylvania. “All physicians treating epilepsy patients should ask targeted questions about these topics during office visits. Not knowing when patients are struggling with these issues impacts our ability to help people with epilepsy achieve truly successful outcomes.”
Detailed study findings
- Discussions of mood- and behavior-related topics occurred in only 13 of 60 visits (22%)
- 34 of 60 patients (57%) reported mood- and behavior-related problems postvisit that physicians did not, including irritability, depression, anxiety and hyperactivity
- Postvisit, neurologists admitted that they are not comfortable asking questions about mood/behavior issues and believe mood issues and treatment are other physicians’ domain
- Side effects were assessed by neurologists in only 44 of 59 (75%) visits with patients already taking antiepileptic medications
- When a visit companion was present, side effect discussions were more robust
- When asked postvisit, 33 percent of neurologists and patients did not agree on what side effects the patient actually was experiencing
- The presence of a robust side effect discussion did not dramatically affect visit length
To build on these findings, Ortho-McNeil Neurologics(R) is now sponsoring a study examining new communication strategies and tools that may help improve dialogue between neurologists and their patients. Findings from this study are anticipated later this year.