New Assessment May Better Screen Adolescents With Epilepsy for Adult Transition

Michael R. Sperling

Data suggests that an epilepsy-specific version of the Transition Readiness Assessment Questionnaire (TRAQ) may be a better indicator of transition readiness from pediatric epilepsy care to an adult epilepsy specialist. Results of the new assessment were presented at the 2019 Child Neurology Society Annual Meeting, October 23-26, 2019 in Charlotte, North Carolina.

Based off the original TRAQ, investigators found more success with the addition of 15 epilepsy-specific questions across 3 of the 5 main TRAQ domains: managing medications, tracking health issues, and managing daily activities. The questions added were based on AAN Epilepsy Quality Measures. Included in the additional epilepsy-specific assessment were questions that addressed knowledge of rescue medications, tracking of seizure frequency, epilepsy type, impact on school/work/activities, and reproductive health counseling for females.The Epi-TRAQ was tested in patients with epilepsy between the ages of 16 and 26.

Validation of the Epi-TRAQ was based on 302 completed forms. Overall average score across all items was 3.73 for Epi-TRAQ versus 3.86 for TRAQ.The internal consistency was high for both Epi-TRAQ (Cronbach’s Alpha [CA] 0.95) and the original TRAQ (CA 0.94). The internal consistency of domains with additional Epi-TRAQ questions was good for managing medications (CA 0.78), and very good for tracking health issues (CA 0.82) and managing daily activities (CA 0.85).

The validated Epi-TRAQ may provide a better assessment of patients as they prepare to transition from pediatric care to an adult epilepsy specialist. In an interview with NeurologyLive, Michael R. Sperling, MD, director, Jefferson Comprehensive Epilepsy Center and clinical neurophysiology laboratory at Jefferson University Hospitals in Philadelphia, discussed the issues that can arise during the transition period, citing that patients often view their pediatrician as part of their family, someone who has been with them since they were an infant, which makes the transition especially hard. This problem is compounded when a patient or their family is not well-prepared for the transition, or the treating physicians don’t work together to ensure the transfer of medical records and specific patient information.

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REFERENCE

Joshi S, Clark S, Beimer N, et al. Developing an Instrument for Screening of Transition Readiness for Adolescents with Epilepsy. Presented at: Child Neurology Society 2019 Annual Meeting. October 23-26, 2019; Charlotte, NC. Abstract 50.