Researchers out of Boston created an automated tool which successfully tracked medication reduction in patients which required long-term monitoring for epilepsy.
- Dose quantification may aid in evaluating biomarkers associated with seizure risk.
“It’s currently challenging to manually review patient charts for medication reductions, as it requires examining records patient by patient,” said Olivia Mezheritsky, BS, from Boston Children’s Hospital’s division of epilepsy and clinical neurophysiology. Speaking at the American Epilepsy Society annual meeting, Mezheritsky explained, “We created a code to automate this process, identifying dosage reductions during specific periods of a patient’s enrollment.”
Study Overview:
The research team aimed to simplify the pre-surgical evaluation process for epilepsy patients requiring long-term monitoring. They also assessed the effectiveness of the automated tool in identifying medication adjustments and potential seizure activity.
The study collected data from a Boston-area hospital between February 2015 and February 2021. Using the REDCap electronic tool, researchers extracted information on ASM release and intake from patients’ electronic health records, focusing on the 24 hours before and during admission.
Patient Groups:
- Phase 1: Patients with ASM reductions from their pre-admission regimen (n = 274).
- Non-Phase 1: Patients without ASM reductions (n = 101).
Medication Adjustment Phases:
- Morning: 3 a.m. to 12 p.m.
- Afternoon: 12:01 p.m. to 4:59 p.m.
- Evening: 5 p.m. to 3 a.m.
Results:
- The average peak ASM concentration for Phase 1 patients occurred 2.6 hours after morning intake, 2.3 hours after afternoon intake, and 2.7 hours after evening intake.
- For non-Phase 1 patients, peak concentrations were 2.6 hours after morning intake, 1.9 hours after afternoon intake, and 2.6 hours after evening intake.
- Mean ASM dose reductions for Phase 1 patients were:
- 41.3% during fewer than half of morning intervals.
- 61.6% during fewer than half of afternoon intervals.
- 57.8% during fewer than half of evening intervals.
Future Implications:
“This tool has the potential to reveal patterns in medication use and dosage changes that might predict future seizures,” Mezheritsky noted.
Sources and Disclosures:
Source: Mezheritsky O, et al. Automated tool for identification of patients with anti-seizure medication reduction in the long-term monitoring unit. Presented at the American Epilepsy Society annual meeting, Dec. 6-10, 2024, Los Angeles.
Disclosures: Mezheritsky reported no relevant financial disclosures. The study was supported by The Epilepsy Research Fund.
