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B.07 Evaluating the single seizure clinic model: findings from a Canadian centre

Published online by Cambridge University Press:  17 June 2016

SA Rizvi
Affiliation:
(Saskatoon)
L Hernandez-Ronquillo
Affiliation:
(Saskatoon)
F Moien-Afshari
Affiliation:
(Saskatoon)
G Hunter
Affiliation:
(Saskatoon)
JF Tellez-Zenteno
Affiliation:
(Saskatoon)
K Waterhouse
Affiliation:
(Saskatoon)
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Abstract

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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.

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Platform Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2016