Bone Health Screening Practices Among Neurologists in Patients on Antiepileptic Drugs: A Quality Improvement Project

Archana A. Patel, Sookee An, Mark Schomer, Kristina Julich, Christopher Elitt, Jamie Heath, Melissa S. Putman, Tobias Loddenkemper

Research output: Contribution to journalArticle

Abstract

Background: Pediatric patients with epilepsy are at risk for low vitamin D levels, increasing the risk for bone fractures, yet standardized bone health screening is not part of routine care. Methods: We surveyed pediatric neurologists (n = 68) at our center regarding screening practices, using an 11-item survey; constructed a bone health treatment algorithm; and developed a training intervention to improve screening rates. Results: The overall survey response rate was 47%. Among respondents, 64% estimated that they screened for bone health less than 25% of the time. Chart review before the intervention demonstrated an overall screening rate of 25.1% (n = 50/199). One year after implementation of a standardized algorithm, the overall screening rates increased to 53.8% (n = 100/186). The frequency of prescribing vitamin D for patients treated with antiepileptic medications increased among general neurologists (preintervention rate 16%, postintervention rate 51%, P < 0.01) as well as among epileptologists (preintervention rate 45%, postintervention rate 57%, P = 0.04). Conclusion: In a relatively short follow-up period, there were significant changes in care patterns regarding screening for bone health in pediatric patients with epilepsy. Further implementation measures are underway to increase bone health screening and care in this population.

Original languageEnglish (US)
Pages (from-to)49-55
Number of pages7
JournalPediatric neurology
Volume102
DOIs
StatePublished - Jan 2020

Fingerprint

Quality Improvement
Anticonvulsants
Bone and Bones
Health
Pediatrics
Vitamin D
Epilepsy
Bone Fractures
Neurologists
Delivery of Health Care
Population
Surveys and Questionnaires
Therapeutics

Keywords

  • Bone health
  • Epilepsy
  • Quality improvement
  • Vitamin D

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Bone Health Screening Practices Among Neurologists in Patients on Antiepileptic Drugs : A Quality Improvement Project. / Patel, Archana A.; An, Sookee; Schomer, Mark; Julich, Kristina; Elitt, Christopher; Heath, Jamie; Putman, Melissa S.; Loddenkemper, Tobias.

In: Pediatric neurology, Vol. 102, 01.2020, p. 49-55.

Research output: Contribution to journalArticle

Patel, Archana A. ; An, Sookee ; Schomer, Mark ; Julich, Kristina ; Elitt, Christopher ; Heath, Jamie ; Putman, Melissa S. ; Loddenkemper, Tobias. / Bone Health Screening Practices Among Neurologists in Patients on Antiepileptic Drugs : A Quality Improvement Project. In: Pediatric neurology. 2020 ; Vol. 102. pp. 49-55.
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