Tonic Clonic Seizure Reduction

Measure purpose: To calculate the number of patients with tonic-clonic seizures who report the same or fewer seizures from baseline calculation

The numerator: Patients who had the same or fewer quantity of seizures in the most recent 12 months compared to the prior 12 months

is divided by

the denominator: Patients diagnosed with epilepsy who have experienced or are currently experiencing tonic-clonic seizures.

Required Exclusions: 

• Patients without documentation of tonic-clonic seizures

Allowable Exclusions

• Patient declines to provide seizure information on date of encounter
• Patient unable to provide seizure information on date of encounter and no care partner is available to provide information or their knowledge is limited

Key Phrases

Seizure frequency must be recorded using one of the below quantity formats. Clinicians and treatment teams must use one of the quantity formats consistently for their patients to accurately calculate outcomes over time:

Current seizure frequency for each tonic-clonic type:

• Innumerable (i.e., ≥10 per day most days)
• Multiple per day (i.e., 4 days per week with ≥2 seizures)
• Daily (i.e., 4 or more days per week)
• Weekly but not daily (i.e., 1–3 per week)
• Monthly but not weekly (i.e., 1–3 per month)
• At least once per year, but not every month (i.e., 10 or fewer in past 12 months)
• Less than once per year
• Frequency not well defined
• Unknown

Time since last seizure for each tonic-clonic type:

• Today
• 1–6 days ago
• 1–4 weeks ago
• 5–12 weeks ago
• 13–26 weeks ago
• 6–12 months ago (27–52 weeks ago)
• 13–24 months ago (53–104 weeks ago)
• More than 2 years ago (more than 105 weeks ago)
• Unsure

Measure Calculation Example

Dr. Baker sees 100 patients between January 1 and December 31, 2020, who are diagnosed with epilepsy and who experience tonic-clonic seizures. Each of these patients had their seizure frequency recorded in the 2020 calendar year. Thirteen of these patients are seen multiple times in 2020 and their seizure frequency is recorded at every visit.

In 2021, all 100 patients return for further care and seizure frequency is again captured by their or their care partners’ reports. Ten of these patients have multiple visits with their seizure frequency data collected. For these patients, the first seizure frequency score collected in 2020 will be compared to the last seizure frequency score recorded in 2021. In 2021, Dr. Baker also sees 25 new patients who report their seizure frequency at every visit.

On December 31, 2021, Dr. Baker’s practice administrator completes a comparison of seizure frequency report for 2021 from 2020. The 25 new patients seen in 2021 are not included in the measure calculation as they do not have the required baseline or index event to make a comparison. Dr. Baker finds that 33% of her patients have the same or fewer tonic-clonic seizures at the last reported seizure frequency captured in 2021 compared to their first reported seizure frequency captured in 2020.

Quality of care = 33/100. Dr. Baker has a score of 33% for this measure.