Epilepsy advocates propose strategies to heighten treatment expectations

On the heels of the nation's largest event dedicated to the epilepsy community, the National Walk for Epilepsy, advocates today announced their recommendations in response to a new national survey uncovering key challenges facing the epilepsy community.

Challenges include gaps in patient-physician communication around medication-related side effects and low public awareness of epilepsy.

According to the survey, sponsored by ORTHO-McNEIL NEUROLOGICS®, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc, 75 percent of epilepsy patients experience medication-related side effects and for the majority, these impact their daily lives, including 57 percent who say work or school are affected. A disconnect exists between patients and healthcare professionals surrounding their discussions on these side effects. While 98 percent of physicians report discussing medication-related side effects with patients, less than half (47 percent) of epilepsy patients report these discussions take place. And, more than one-quarter of patients report they sometimes feel reluctant to broach this topic during office visits. Not surprisingly, healthcare professionals underestimate the number of patients experiencing medication-related side effects, estimating this figure at just 43 percent. The most common side effects according to the survey are fatigue, poor memory, weight gain or weight loss and loss of concentration.

“These findings suggest treatment expectations among epilepsy patients are simply too low. According to the survey, 61 percent of people with epilepsy believe that side effects are just something they have to live with,” said roundtable moderator and Epilepsy Foundation CEO and President Eric Hargis. “People with epilepsy should be proactive in discussing their treatment plans, opening up about the side effects they experience and sharing how these side effects are affecting their lives.”

Panelists at the nine-person roundtable included some of the nation's premiere epileptologists, patients and caregivers and celebrity advocates, including Greg Grunberg, star of NBC's television series "Heroes" and father of a son with epilepsy, and New York Giants defensive back Geoffrey Pope whose grandmother has epilepsy.

Improving Treatment Plans

Roundtable participants agreed that people with epilepsy and healthcare professionals should work together to ensure treatment plans are tailored to the individual. According to the survey, 85 percent of patients would prefer to have a more active role in making their treatment decisions.

“It is crucial for patients to speak up and be a part of developing their treatment model,” said Georgia Montouris, M.D., director of epilepsy services at the Boston University School of Medicine and Boston Medical Center.

Healthcare professionals surveyed say they would recommend an alternative treatment plan at least half the time for those patients experiencing medication-related side effects. "We need to increase the focus on individualizing treatment plans and strive for optimal balance between seizure control and minimization of side effects so that we can improve the overall well-being of people with epilepsy,” added Dr. Montouris.

Roundtable participant Caitlin Purcell, 17, explained how her healthcare professional started her on one medication, but when she was still experiencing seizures he added new medications to her regime to help her further manage her condition. Physicians often try a variety of therapy mixes to customize the treatment approach, “and Caitlin's physician was trying to find the right ‘cocktail' for her,” noted Dr. Mark Spitz, head of the Adult Comprehensive Epilepsy Program at the University of Colorado.

Participants also discussed the need for new treatments. “We need to continue funding research and development as there is a need for drugs that help us better straddle this balance until a cure for epilepsy can be found," said Hargis.

Other recommendations for improving communication and treatment plans included:

• Patients and caregivers should advocate for themselves and discuss their treatment plans, side effects and what other steps can be taken with their healthcare professionals. “As long as there is seizure activity, there are still things that can be done or treatments that can be tried,” said Grunberg.
• Patients should strive for a more individualized treatment plan by sharing a daily diary or record of how they are feeling, any medication side-effects or breakthrough seizures they experience with their healthcare professional.
• Patients and caregivers, as well as healthcare professionals, should raise their standards and not settle if the patient is still experiencing seizures or side effects. “It's not a trade-off. We may not be able to get every patient to the point of experiencing no seizures and no side effects, but we should never stop trying,” said Dr. Montouris.
• Finally, panelists encouraged patients to not hesitate to seek a second opinion when patients are not achieving their treatment goals.

Raising Public Awareness of Epilepsy

According to the survey, three-quarters of people with epilepsy and 90 percent of physicians feel that the general public is not well-informed about epilepsy. Roundtable participants agreed that this is a major cause for the stigma surrounding epilepsy and some shared their stories of how this has impacted their lives.

“The other kids (in school) are sometimes afraid of me. And sometimes even if they want to have me over after school, their parents are afraid, especially if they haven't seen me have a seizure,” explained 14-year-old panelist Carly Richards of Chicago.

Participants addressed the need for continued public education programs that focus on eliminating stigma associated with epilepsy, such as the March 29th annual National Walk for Epilepsy. The panelists encouraged all people who have epilepsy or know someone with the condition to speak out and share their experiences.

“We are at a tipping point for bringing epilepsy out in the open,” said Grunberg. “We need to continue the dialogue we started here today to increase awareness and break down the stigma that is unfairly associated with this disorder.”

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