Approximately 50% of children with epilepsy continue to have epilepsy into adulthood. Complex pediatric epilepsy syndromes and associated comorbidities make the transition process from pediatric to adult health care systems difficult for youth with epilepsy, their caregivers, and families. Transition is a gradual process and is highly individualized. Pediatric epilepsy patients > 13 years of age or caregivers should be counseled once a year with a documented neurological transition plan of care initiated and updated. This counseling should include a discussion about ALL of the following in the transition care plan, but not limited to:
- Medical plan (pertinent medical and surgical history related to neurological condition, current and past neurological medications with adverse effects, previous and future needed testing)
- Discussion of existing office transition policy with expected year of transition given to patient and caregiver
- Patient self-management skills assessment
- Transition readiness assessment
- Patient current and expected legal competency
- Patient plan for employment, school, vocation, placement (for profound intellectual disability patients), etc.
- Emergency plans (medical power of attorney, living will, DNR, plans for guardianship for patients with profound intellectual disability)
- Name of provider providing or accepting care of neurological condition (at time of transition only)
This is a self-directed, web-based activity designed to help you evaluate the delivery of care in your clinical setting. The activity is comprised of 3 stages:
- Stage A - Perform chart reviews, evaluate and reflect on results of the chart audit, and self-identify areas for improvement.
- Stage B - Based on results of Stage A, develop and implement a plan to optimize proper transition of an adolescent patient to adult epilepsy care utilizing the 2018 American Academy of Neurology and Child Neurology Society Quality Measure.
- Stage C - Evaluate the impact of your plan and perform a second chart review for patients seen after your plan implementation.
Epileptologists, neurologists, general physicians, and other interested healthcare professionals
Accreditation
The American Epilepsy Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The American Epilepsy Society designates this enduring material activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
International Credits: The American Medical Association has determined that non-US. licensed physicians who participate in this CME activity are eligible for AMA PRA Category 1 Credits™.
Physician Assistants: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 20 hours of Category 1 credit for completing this program.
Instructions for Participation to Earn CME Credit
- Read the needs statement, target audience, learning objectives, and planner/faculty disclosures.
- Complete stages A, B and C for the activity.
- Complete the evaluation.
Maintenance of Certification
The American Board of Psychiatry and Neurology has reviewed the PI-CME activity "Improving Outcomes for Transitions from Pediatric to Adult Epilepsy Care" and has approved this program as part of a comprehensive Improvement in Medical Practice (PIP) program, which is mandated by the ABMS as a necessary component of maintenance of certification.
Faculty, Planning Committee, Reviewers’ Disclosures of Financial Relationships
In accordance with the ACCME Standards for Commercial Support, the AES requires that any person who is in a position to control content of a CME activity must disclose all relevant financial relationships that they have with a commercial interest. Unless otherwise indicated (*), none of the planners or faculty of this activity have any financial relationships to disclose. All relevant financial relationships with commercial interests have been mitigated. The following individuals contributed to this activity’s content.
Planners
Gabriel U. Martz, MD, Norton Healthcare, Louisville, KY
Dr. Martz has indicated he has no financial relationships to disclose relevant to this activity.
Timothy E. Welty, MA, PharmD, FCCP, Drake University, Des Moines, IA
Dr. Welty has indicated he has no financial relationships to disclose relevant to this activity.
Faculty
*Anup D. Patel, M.D., Nationwide Children’s Hospital, Columbus, OH
Dr. Patel reports the following financial relationships relevant to this activity:
- Consulting fees: GW Pharmaceuticals, Liva Nova, Supernus, UCB Pharma
- Contracted research: Upsher-Smith, Liva Nova, GW Pharmaceuticals
*Aashit K. Shah, M.D., Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA
Dr. Shah reports the following financial relationships relevant to this activity:
- Contracted research: Eisai, SK Life sciences, Xenon
Anu Venkat, M.D., Saint Peters University Hospital, New Brunswick, NJ
Dr. Venkat has indicated she has no financial relationships to disclose relevant to this activity.
CME Reviewer
Elaine Sing-Wah Seto, MD, PhD
Dr. Seto has indicated he has no financial relationships to disclose relevant to this activity.
AES Staff
Joy Keller, MS, RD, MSLIS, AES Senior Manager, Clinical Activities
Cristina Graham, AES Director, Education and Professional Development
AES Staff involved in this activity have indicated they have no financial relationships to disclose relevant to this activity.
Policy on Commercial Support and Conflict of Interest
As an ACCME-accredited provider the American Epilepsy Society must ensure 100% compliance with the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities. The American Epilepsy Society has implemented mechanisms prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity.
Resolution of Conflicts of Interest
It is the policy of the American Epilepsy Society to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. In accordance with the ACCME Standards for Commercial Support of CME, the AES implemented the mechanisms of prospective peer review of this CME activity, to identify and resolve any conflicts. Additionally, the content of this activity is based on the best available evidence.
Unapproved Use Disclosure
The American Epilepsy Society requires CME authors to disclose to learners when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information. Information about pharmaceutical agents/devices that is outside of U.S. Food and Drug Administration approved labeling may be contained in this activity.
Contact Information
For further information on this activity contact the American Epilepsy Society at education@aesnet.org or call 312.883.3800.
Privacy and Confidentiality
The American Epilepsy Society respects the privacy and confidentiality of users of this CME activity. You may access the privacy statement for this activity here.
Disclaimer
This CME activity is for educational purposes only and does not constitute the opinion or endorsement of, or promotion by, the American Epilepsy Society. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label, investigational and/or experimental uses.