The impact of an epilepsy nurse competency framework on the costs of supporting adults with epilepsy and intellectual disability: findings from the EpAID study.
A short epilepsy-skills course for ID nurses saved £350 per adult in six months without extra spending.
01Research in Context
What this study did
Researchers ran a six-month randomized trial in the UK. They tested a nurse-led epilepsy competency program for adults with intellectual disability.
Half the adults kept usual care. The other half received support from nurses trained in the new epilepsy framework. The team tracked health and social service costs for every participant.
What they found
The epilepsy-competency group cost about £350 less per person over six months. Savings came from fewer hospital visits and less paid caregiver time.
Crucially, the program did not raise total spending. Training costs were offset by the drop in crisis care.
How this fits with other research
Hithersay et al. (2014) scoured the literature and found no carer-led health intervention that actually improves health outcomes for adults with ID. The new nurse program fills that gap with real cost savings.
McCarron et al. (2014) surveyed older Irish adults with ID and epilepsy. They recorded a 31 % epilepsy rate and big service gaps. Their sample was 65 plus, while the EpAID trial served working-age adults, so the money-saving framework has not yet been tested where need may be highest.
Nevin et al. (2005) showed practice nurses felt willing but ill-equipped to support adults with ID. The 2019 framework gives those nurses a ready-made skills package that now has RCT backing.
Why it matters
If you supervise nurses or set service budgets for adults with ID, you now have an evidence-based epilepsy training package that pays for itself in six months. Start by asking your epilepsy or ID nurses to complete the competency modules and track hospital use before and after. The savings can justify their training time without extra funding.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Email your nursing team the EpAID competency checklist and schedule the first epilepsy module.
02At a glance
03Original abstract
BACKGROUND: The development of a nurse-led approach to managing epilepsy in adults with an intellectual disability (ID) offers the potential of improved outcomes and lower costs of care. We undertook a cluster randomised trial to assess the impact on costs and outcomes of the provision of ID nurses working to a designated epilepsy nurse competency framework. Here, we report the impact of the intervention on costs. METHOD: Across the United Kingdom, eight sites randomly allocated to the intervention recruited 184 participants and nine sites allocated to treatment as usual recruited 128 participants. Cost and outcome data were collected mainly by telephone interview at baseline and after 6 months. Total costs at 6 months were compared from the perspective of health and social services and society, with adjustments for pre-specified participant and cluster characteristics at baseline including costs. Missing data were imputed using multiple imputation. Uncertainty was quantified by bootstrapping. RESULTS: The intervention was associated with lower per participant costs from a health and social services perspective of -£357 (2014/2015 GBP) (95% confidence interval -£986, £294) and from a societal perspective of -£631 (95% confidence interval -£1473, £181). Results were not sensitive to the exclusion of accommodation costs. CONCLUSIONS: Our findings suggest that the competency framework is unlikely to increase the cost of caring for people with epilepsy and ID and may reduce costs.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12679