Ancillary Service Utilization Patterns in Functional Neurological Disorder Patients: A Retrospective Cohort Study
Marlie Winslow1, David Galarneau2
1University of Queensland-Ochsner Clinical School, 2Psychiatry, Ochsner Clinic Foundation
Objective:
To assess healthcare utilization patterns and adherence to standard treatment of patients after receiving a diagnosis of a functional neurological disorder (FND).
Background:
FND is the second most common diagnosis presenting to neurology clinics. It is a "rule in" neuropathophysiological diagnosis made through neurological exam and, in some cases, functional brain imaging such as EEG. While the effectiveness of multidisciplinary management has been well-documented, less is known about the care pathways of FND patients in ancillary care and the potential differences in types and frequency of encounters between various presentations of FND cases. This study describes ancillary care utilization pre- and post-diagnosis in a cohort of FND patients. It will also describe potential differences in utilization between identified subtypes of FND — motor, sensory, seizures or attacks, and mixed — and other patient groupings that may emerge from study results of this heterogeneous sample.
Design/Methods:
This is a retrospective cohort study in which patients will be stratified into pre-diagnosis and post-diagnosis groups. The study period will be 48 months: 24 months before and 24 months after diagnosis. We will use MRN cross-matched clinical records to gather data which will include all patients at Ochsner Clinic Foundation with an International Classification of Diseases, Tenth Revision (ICD-10) diagnosis of functional neurological disorder (F44.4–F44.7) via Epic Electronic Health Record) between January 1, 2012 and January 1, 2022. Inclusion criteria include patients with an ICD-coded diagnosis of FND with at least one encounter at an Ochsner facility between dates listed. Exclusion criteria include patients without a diagnosis of FND but with another functional presentation (i.e., irritable bowel syndrome, fibromyalgia).
Results:
The results of this promissory abstract are pending and will be complete by April 2024. In the last ten years, there were 6,492 patients with an FND diagnosis at this facility.