Accreditation program increased availability of specialty epilepsy care in US

Specialty epilepsy care availability increased in the U.S. following implementation of the National Association of Epilepsy Centers’ accreditation program, according to study results published in Neurology.

“Kaiboriboon and colleagues reviewed [National Association of Epilepsy Center (NAEC)] annual report data between 2003 and 2012 and reported growth in number of epilepsy centers, total surgeries and total [vagus nerve stimulator] insertions across NAEC centers,” Adam P. Ostendorf, MD, of the department of pediatrics at Nationwide Children's Hospital and Ohio State University, and colleagues wrote. “Since then, NAEC implemented its accreditation program and the number of centers accredited by NAEC greatly expanded. This article describes recent data trends and current state of resources and practice across NAEC member centers and identifies several future directions for driving systematic improvements in epilepsy care.”

The researchers examined data reported in 2012, 2016 and 2019 from all level 3 and level 4 epilepsy centers accredited by the NAEC. Between 2012 and 2019, they noted an increase from 161 to 256 in the number of accredited centers. The largest increases occurred among adult- and pediatric-only centers. They also reported growth of 41% in epilepsy monitoring unit admissions, 26% in EMU beds and 109% in epileptologists per population, as well as broad expansion of access to specialized testing and services.

For the most significant growth in procedure volumes, Ostendorf and colleagues reported 61% growth in laser interstitial thermal therapy, 114% growth in responsive neurostimulation implantation and 152% growth in intracranial monitoring without resection. Corpus callosotomies and vagus nerve stimulator implantations declined 12.8% and 2.4%, respectively. Growth of 5.9%, 11.9% and 13.1% in temporal lobectomies, extratemporal resections and hemispherectomies/otomies, respectively, lagged the 59% growth in centers, which led to a decrease in median volumes of these procedures per center.

“Specialty epilepsy care in the U.S. has significantly changed over the study period,” Ostendorf and colleagues wrote. “Additional studies are required to better understand the influence of epilepsy center characteristics on testing, treatment and outcomes. Epilepsy centers are key to standardizing access and delivery of epilepsy care across health care networks.”