Core Concepts
Primary care providers play a crucial role in referring patients with epilepsy to neurologists for optimal care and management.
Abstract
The Centers for Disease Control and Prevention (CDC) highlights the importance of primary care providers in referring patients with epilepsy to neurologists for specialized care. Referral patterns, barriers, and solutions are discussed in detail, emphasizing the critical role of primary care in managing epilepsy effectively.
Referral Patterns
- 90% of primary care providers would refer a patient with new-onset seizures to a neurologist.
- 40% of primary care providers do not refer patients with epilepsy to a neurologist when treatment fails or seizure activity changes.
- Factors influencing referrals include appointment availability, communication with neurologists, and insurance coverage.
Barriers to Referral
- Proximity to specialists, especially in rural areas, poses a challenge.
- Shortage of neurologists in many states, leading to long wait times.
- Transitioning adolescents with epilepsy to adult specialists is complex.
Management Strategies
- Initiating medication after the first seizure is a decision point for primary care providers.
- Importance of taking a good patient history to determine the nature of seizures.
- Recommendations for imaging and workup before specialist appointments.
Self-Management and Support
- Primary care's role in promoting self-efficacy and holistic health behaviors in epilepsy management.
- CDC's Managing Epilepsy Well (MEW) Network offers evidence-based programs for patients.
- Use of technology, telehealth, and virtual interventions to improve care coordination.
Stats
The CDC estimates that 1.1% of US adults have epilepsy.
90% of primary care providers would refer a patient with new-onset seizures to a neurologist.
40% of primary care providers do not refer patients with epilepsy to a neurologist when treatment fails or seizure activity changes.
By 2025, demand for neurologists is projected to exceed supply in 41 states.
Quotes
"We found that 40% of primary care providers did not indicate that they would refer their patient with epilepsy to a neurologist when their patient fails to respond to treatment, or if they have a change in seizure activity." - Rosemary Kobau, MPH
"One of the great problems in epilepsy care is a sort of sense of complacency." - Fred Lado, MD, PhD