11:00 - 11:20 amSunday, September 7
LK 120
The POEM study: Testing the impact of a digital health platform in U.S. veterans with epilepsy
LK 120
The POEM study: Testing the impact of a digital health platform in U.S. veterans with epilepsy
Assistant Professor of Neurology, UCSF/VAHSF
PurposeThe purpose of the POEM (Policy for Optimal Epilepsy Management) study was to assess the impact of a digital health management platform in a population of U.S. Veterans with epilepsy.  The digital... Read more

Description

Purpose

The purpose of the POEM (Policy for Optimal Epilepsy Management) study was to assess the impact of a digital health management platform in a population of U.S. Veterans with epilepsy.  The digital intervention included a social media forum, condition-specific tracking tools, and educational resources.

Method

We conducted a pragmatic clinical trial in U.S. Veterans with epilepsy that had not previously used the PatientsLikeMe platform (www.patientslikeme.com).  We utilized mixed recruiting techniques, including direct patient contact, mailing campaigns, and social media advertising.  Patients registered through an online study website and completed informed consent and validation queries before entering the study.  Participants initially completed two validated surveys that represented the primary study outcomes:  the Epilepsy Self-Management Scale (ESMS) and the Epilepsy Self-Efficacy Scale (ESES), two measures of patient self-knowledge used extensively in epilepsy clinical trials.  Following online completion of these surveys, participants were introduced to the PatientsLikeMe platform and were asked to engage at their own discretion.  After a period of six weeks, each study member was asked to complete the two surveys again. Additionally, site usage data was collected throughout the six week intervention period.  A nominal incentive was offered for full study completion.

Results

A total of 249 Veterans with epilepsy consented, were validated, and joined the online platform.  The mean age of all participants was 50.2 years, 80.7% were male, and 75.1% were non-Hispanic white, all consistent with U.S. Veteran demographics. 92 participants (36.9%) completed the second survey set at the conclusion of the study.  Using both paired t-test and Wilcoxon sign-rank methods, both the ESMS (p 0.01) and ESES (p 0.03) total scores demonstrated statistically significant improvements at the end of six weeks participation.  Additionally, the ESMS information management subscale displayed significant improvement with a p-value of <0.001.  Among trial completers, 15% posted comments on the epilepsy forum, and 29% used the private messaging feature to communicate with other community members.

Conclusion

This first-time, pragmatic study of an online health management platform demonstrates statistically significant improvements in established epilepsy metrics of patient self-management and self-efficacy.  In particular, the information management subscale of the ESMS demonstrate a very strong positive change. This work demonstrates the potential impact of digital health solutions in epilepsy and serves as a foundation for further research in this area.

Dr. John Hixson is an Assistant Professor of Neurology at UCSF and the San Francisco VA Medical Center.  Additionally, he serves as Associate Chief of Staff for Clinical Informatics at the SF VAMC, and is integral in the national Health Informatics Initiative.  Through this work, Dr. Hixson is primarily focused on patient-facing software development and the treatment of patient-generated health data.  He also is the principal investigator for a national VA-based study of the PatientsLikeMe platform in a cohort of Veterans with epilepsy.  Dr. Hixson attended medical school at Johns Hopkins University and completed his Neurology residency at the University of Pennsylvania.

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