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AAN 2021 Study Preview: Social Determinants and Epilepsy

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A talk with Dr. Joseph Sirven about AAN presentation The Role of Social Determinants of Health in Epilepsy Treatment Delays

What are the highlights that attendees should take away from your presentation?

The treatment gap and treatment delays among the epilepsy community are still far too high. Within the Arizona Medicaid population, several social determinant of health (SDoH) factors were found to correlate with increased odds of going untreated and/or receiving delayed care: care setting, age, race, marital status, homelessness, and employment status. Identifying these key factors is the first step in understanding the underlying drivers contributing to epilepsy treatment gaps and delays.

What are the key findings from your study?

Within the Arizona Medicaid population, the epilepsy treatment gap (individuals that are diagnosed with epilepsy but fail to receive treatment) remains high (40.6%). Of those that do receive treatment, the time delay from the day that they are diagnosed to when they actually receive treatment in the form of anti-seizure drugs is extensive (mean and median delay of 180 and 73 days, respectively). Several key SDoH measures (mentioned above) were investigated and found to correlate with increased odds of patients going untreated and/or receiving delayed care. These measures could be extrapolated to the larger U.S. population.

How do these findings and/or conclusions potentially impact clinical practice? 

The importance of social factors on health outcomes is now widely known. Clinicians must take into account the lived experiences of their patients. Knowing and understanding the SDoH factors that contribute to epilepsy treatment delays can aid clinicians and organizations in structuring the right resources to ensure individuals diagnosed with epilepsy actually receive and follow-through with treatment.

What else would you like attendees to know about the presentation?

Our study underscores the need for a deeper understanding of the complex interplay of SDoH factors on epilepsy care. Widening the scope of epilepsy research to consider the lived experiences of traditionally under-examined populations is vital to reducing disparate health outcomes among individuals with epilepsy from all backgrounds.

Dr. Sirven receives grant support from UCB Pharma and has been a consultant for Neurelis, Medtronic, Gore, and the Federal Aviation Administration.

Illustration by April Brust

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