American Epilepsy Society 2025 Annual Meeting, December 5 – 9, Atlanta, Conference Coverage
Optimizing Epilepsy Counseling for Women of Reproductive Age: A Quality Improvement Initiative Using EMR-Integrated Tools and Structured Education
Researchers at the University of Mississippi Medical Center implemented a quality improvement initiative to address inconsistent reproductive health counseling for women with epilepsy, demonstrating that electronic medical record integration and structured education can enhance clinical practice standardization.
Women with epilepsy face significant reproductive health challenges, including teratogenic risks from antiseizure medications, altered drug metabolism during pregnancy, and potential interactions with hormonal contraceptives. Despite established clinical guidelines addressing these concerns, provider counseling remains variable and often inadequate, leaving patients without critical information for informed reproductive decision-making.
The initiative involved 13 neurology residents across training levels who completed pre- intervention assessments measuring knowledge and confidence in counseling women of reproductive age with epilepsy. Baseline confidence surveys revealed substantial preparedness gaps, with residents rating themselves lowest in discussing breastfeeding safety while taking antiseizure medications. However, residents strongly agreed that reproductive counseling should be routine in epilepsy care, indicating recognition of its importance despite limited comfort.
Following a structured didactic lecture on women’s epilepsy issues, researchers introduced an EMR-integrated SmartPhrase tool designed to standardize patient education materials and streamline documentation. Post-intervention assessments showed modest knowledge improvements from 52.3% to 59.2% correct responses, though this increase was not statistically significant.
The SmartPhrase tool received overwhelmingly positive feedback across five evaluation domains. Residents rated it highly for ease of use, enhancement of clinical discussions, likelihood of continued use, standardization of education, and recommendation to colleagues, with average ratings of 4.6 or higher on a 5-point scale. Notably, 62% of participants gave perfect scores across all categories, and all responses were 4.6 or higher.
The researchers acknowledge limitations including immediate post-session assessment rather than real-world evaluation. They recommend longitudinal studies examining actual clinical utilization patterns, documentation compliance with quality measures, and patient-centered outcomes. The combination of structured education and technology-enabled standardization shows promise for improving reproductive health counseling consistency, though broader implementation across diverse healthcare settings requires further validation.
Patient Satisfaction and Safety Outcomes with REMI™, a Novel Wearable Ambulatory EEG Monitoring System
Researchers at Yale University evaluated a novel wearable electroencephalography system designed to overcome limitations of traditional ambulatory EEG monitoring, demonstrating high patient satisfaction and diagnostic utility for extended brain activity recordings.
Traditional ambulatory EEG monitoring typically captures only three days of brain activity, potentially missing infrequent seizures or diagnostic events in patients requiring spell characterization. The Remote EEG Monitoring System, consisting of just four small wireless sensors, enables extended monitoring periods while allowing patients greater mobility and comfort compared to conventional systems with multiple electrode attachments.
The prospective study enrolled 21 patients who underwent extended monitoring averaging 26.4 days, with some recordings lasting up to 28 days. During the first three days, patients wore both the REMI system and traditional ambulatory EEG simultaneously for comparison. Three board- certified epileptologists independently reviewed the recordings for clinical evaluability.
Among 13 patients with completed analysis, the system achieved diagnostic yield in 69.2% of cases, successfully meeting referral objectives such as spell characterization or informing therapeutic decisions including surgical versus medical management. Patient acceptance proved exceptionally high, with 90% reporting high satisfaction and 95% willing to recommend the system to others. All patients preferred REMI over traditional EEG, citing superior comfort, ease of use, mobility freedom, and reduced sleep disruption.
Most patients (70%) successfully applied the sensors independently, while 30% required caregiver assistance. Adverse events occurred in 80% of subjects but consisted primarily of mild, manageable skin irritation and adhesive-related issues. No adverse events necessitated study discontinuation.
The extended monitoring capability enabled diagnostic clarification in multiple cases where shorter recordings would have been inconclusive. The researchers note that analysis remains ongoing for remaining subjects and will be completed before final presentation. Future work will refine patient selection criteria and identify clinical scenarios where this technology delivers maximum diagnostic benefit.