Friday, April 4, 2025
4/4/2025
Expanding epilepsy self-management support in healthcare networks (EXPAND) - Epilepsy affects over three million Americans and causes substantial disability, reduced quality of life, risk of psychological co-morbidity, and early mortality. Epilepsy self-management programs improve select health and quality of life outcomes, but these programs are underutilized in clinical settings. Self-Management for People with Epilepsy and a History of Negative Health Events (SMART) is an evidence-based self-management program that can reduce epilepsy complications and improve quality of life and functioning. Unfortunately, time-limited clinic visits don’t optimize clinicians’ ability to refer to such programs. The proposed project (Expanding epilepsy self-management support in healthcare networks /EXPAND) responsive to Component 1 of CDC-RFA-DP-23-0007 builds on this project team’s success in capturing data from the electronic health record (EHR) to enhance referrals for appropriate clinical intervention. The team is led by clinicians and researchers experienced in epilepsy care from the University of Cincinnati/UC Health (UC Health), University of Iowa Hospitals and Clinics (UIHC) and University Hospitals Cleveland/Case Western Reserve University School of Medicine (UHC) and has a multi-year history of successful collaboration. The proposed project will reach rural and urban communities in Ohio, Iowa and the broader mid-western U.S. region and target vulnerable and/or underserved people with epilepsy including those with mental health comorbidity, transitional age young adults and those with suboptimal seizure control. Both UIHC and UC Health have large, established epilepsy centers. EHR-based screening, identification of eligible PWE, clinician alerts for eligible patients and data gathering in follow up are all currently operational at UC Health. In Year 1 the team will implement this operational flow with EHR screening tools and provider alerts for SMART at UC Health and UIHC sites. Both sites will train SMART nurse and peer educators and site teams will work with providers to enhance SMART referrals. UHC will work with the two recruiting sites to collect and manage data on screening, recruitment, completion, and outcome follow-up. The study team will convene and work closely with a stakeholder advisory board (SAB) to ensure that project implementation strategy is responsive to the needs of people with epilepsy. Year 1 targets are 1) two sites screening and enrolling; 2) 6 nurse educators and 6 peer educators trained; and 3) 80 participants in year 1 and 120 participants per year in subsequent years. Outcomes anticipated include: 1) Improved awareness of self-management supports among patients and providers including EHR pop-up alerts for eligible PWE; 2) Increased referrals and enrollment into SMART programs by providers; 3) Increased completion of SMART programs by PWE with improved quality of life and decreased hospital utilization; 4) implementation of EHR-based identification and referral to SMART programs at additional healthcare settings. As stated in letters of support, dissemination will be through professional meetings, local and regional patient support groups, and through the ongoing ECHO program. The experienced UHC team will manage data. In summary, we propose a multistep plan informed by strong preliminary results, implemented by an experienced team to identify, refer, and follow PWE through a self-management program. Additional project goals are to export the plan to other health care organizations and serve as a model for scale-up in other healthcare settings.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).