B.07 Evaluating the single seizure clinic model: findings from a Canadian centre. (17th June 2016)

• Record Type: Journal Article
• Authors: Rizvi, SA; Hernandez-Ronquillo, L; Moien-Afshari, F; Hunter, G; Tellez-Zenteno, JF; Waterhouse, K
• Is Part Of: Canadian journal of neurological sciences. Volume 43(2016)Supplement 2
• Page Start: S10
• Page End: S11
• Publication Date: 2016-06-17
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2016.66
• Languages: English
• ISSNs: 0317-1671

Abstract

Abstract : Background: The effect of the single seizure clinic (SSC) model on patient diagnosis, work-up, wait-times, and clinical care is poorly characterized. This study assesses patient characteristics and evaluates the impact of a SSC model on wait-times and access to care.Methods: A prospective study of all patients (n=200) referred to our SSC for first-seizure evaluation. Demographic, clinical, and paraclinicial variables were analyzed against a historical cohort. Binary logistic regression analysis was performed to predict impact of dichotomized variables on diagnosis of epilepsy. Diagnostic concordance between SSC nurses and epileptologists was also assessed.Results: Predominant referral sources were emergency department physicians and general practitioners. Mean wait-time for first assessment was significantly reduced by 70.5% employing the SSC model versus historical usual care. A diagnosis was established at first-contact in 80.5% of cases while 16.0% of patients required a second visit. Eighty-two patients (41.0%) were diagnosed with epilepsy. The most common non-seizure diagnosis was syncope (24.0%). An abnormal EEG was found in 93.9% of patients diagnosed with epilepsy. Sixty-three patients were started on anti-epileptic drugs. In 18% of cases driving restrictions were initiated by the SSC. There was moderate correlation between SSC nurses and physicians (kappa=0.54; p<0.001) diagnoses.Conclusions: The SSC model reduces wait-times, streamlines assessments, and impacts clinical care decisions.