RT Journal Article SR Electronic T1 Epilepsy Treatment Complacency in Patients, Caregivers, and Health Care Professionals JF Neurology: Clinical Practice FD Lippincott Williams & Wilkins SP 377 OP 384 DO 10.1212/CPJ.0000000000001066 VO 11 IS 5 A1 Penovich, Patricia E. A1 Stern, John M. A1 Becker, Danielle A. A1 Long, Lucretia A1 Santilli, Nancy A1 McGuire, Lynanne A1 Peck, Eugenia Y. YR 2021 UL http://cp.neurology.org/content/11/5/377.abstract AB Objective To explore the perspectives of adult patients with epilepsy, caregivers, and health care professionals (HCPs) on treatment for seizures and treatment decisions, we developed and administered the STEP Survey (Seize the Truth of Epilepsy Perceptions).Methods Participants were recruited from online panel M3 and by Rare Patient Voice and completed the self-administered online STEP Survey. Analysis of variance and chi-square tests were used for group comparisons.Results The STEP Survey was completed by 400 adult patients, 201 caregivers, and 258 HCPs. Patients estimated reporting 45% of their seizures to their HCP, whereas caregivers estimated 83% and HCPs estimated 73% were reported. The most common reason for not reporting seizures was that the seizures were not serious enough to mention (patients 57%; caregivers 66%). A minority of patients (25%) and caregivers (30%) were very or extremely likely to ask their HCP about changing antiseizure medication (ASM) in the next 12 months. The HCP was most frequently selected by patients, caregivers, and HCPs as the person who initiates discussion of changing ASMs (patients 73%/caregivers 66%/HCPs 75%) and increasing ASM dosage (patients 77%/caregivers 68%/HCPs 81%). A majority of patients (65%) and caregivers (68%) somewhat or strongly agreed that they do not change ASMs due to fear of getting worse. HCPs perceive this fear less often, stating that 50% of their patients feel afraid when a second ASM was added.Conclusions Improved reporting of all seizures, discussion of treatment changes, and the impact of fear on treatment decisions provide opportunities to reduce complacency and optimize patient outcomes.