Automated tool tracks medication changes for long-term epilepsy monitoring

Key takeaways:

• An automated tool classified patients with and without antiseizure medication reduction.
• Dose quantification may be useful for biomarker evaluation of seizure risk.

LOS ANGELES — A novel automated data-extraction tool successfully tracked daily antiseizure medication changes for individuals requiring long-term monitoring for epilepsy, data show.

“Right now, it’s hard just looking at patients’ charts to see if there’s any reduction in their medication. You would have to look patient by patient,” Olivia Mezheritsky, BS, from the division of epilepsy and clinical neurophysiology in the department of neurology at Boston Children’s Hospital, told Healio at the American Epilepsy Society annual meeting. “We created a code that automates the whole process, to see what time period during their enrollment, if they had any reduction in dosage.”

Mezheritsky and colleagues sought to streamline the pre-surgical evaluation process for individuals with epilepsy who may require longer term monitoring, while also examining the efficacy of the automated tool in tracking medication adjustment and possible seizure activity.

They collected data from patients at a Boston-area hospital between February 2015 and February 2021. The researchers examined antiseizure medication (ASM) release and intake from patients’ electronic health records, extracting data for the 24 hours before and during admission and captured with the REDCap electronic tool.

Patients were split into two groups: those with reduced ASM from their pre-admission regimen (phase 1; n = 274) and those with no reduction (non-phase 1; n = 101).

Medication adjustments were subsequently examined in three phases: morning (3 a.m. to 12 p.m.), afternoon (12:01 p.m. to 4:59 p.m.) and evening (5 p.m. to 3 a.m.).

According to the results, mean peak ASM concentration for phase 1 patients was 2.6 hours after morning intake, 2.3 hours following afternoon intake and 2.7 hours after evening intake; for non-phase 1 individuals, 2.6 hours after morning intake, 1.9 hours following afternoon intake and 2.6 hours after evening intake.

Data further showed a mean ASM dose reduction of 41.3% in fewer than half of morning intervals, 61.6% in fewer than half of afternoon intervals and 57.8% in fewer than half of evening intervals.

“I hope that in the future, people are able to use this to see if there’s any patterns with specific medications, or if a change in medication dosage will predict a seizure in the future,” Mezheritsky said.