Singh, G;
Sharma, S;
Bansal, RK;
Setia, RK;
Sharma, S;
Bansal, N;
Chowdhury, A;
... Sander, JW; + view all
(2019)
A home-based, primary-care model for epilepsy care in India: Basis and design.
Epilepsia Open
10.1002/epi4.12311.
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Abstract
Epilepsia Open published by Wiley Periodicals Inc. on behalf of International League Against Epilepsy. Objectives: A cluster-randomized trial of home-based care using primary-care resources for people with epilepsy has been set up to optimize epilepsy care in resource-limited communities in low- and middle-income countries. The primary aim is to determine whether treatment adherence to antiepileptic drugs is better with home-based care or with routine clinic-based care. The secondary aims are to compare the effects of the two care pathways on seizure control and quality of life. Methods: The home-based intervention comprises epilepsy medication provision, adherence reinforcement, and epilepsy self-management and stigma management guidance provided by an auxiliary nurse-midwife equivalent. The experimental group will be compared to a routine clinic-based care group using a cluster-randomized design in which the unit of analysis is a cluster of 10 people with epilepsy residing in an area cared for by a single accredited government grass-roots health care worker. The primary outcome is treatment adherence as measured by monthly tablet counts supplemented by two self-completed questionnaires. The secondary outcomes include monthly seizure frequency, time to first seizure (in days) after enrollment, proportion of patients experiencing seizure freedom for the duration of the study, and quality of life measured by the “Personal Impact of Epilepsy Scale,” all assessed by an independent study nurse. Results: The screening phase and neurologic evaluations and randomizations have been recently completed and follow-up is underway. Significance: The results of the trial are likely to have substantial bearing on the development of governmental policies and strategies to provide coverage and care for patients with epilepsy in resource-limited countries.
| Type: | Article |
|---|---|
| Title: | A home-based, primary-care model for epilepsy care in India: Basis and design |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/epi4.12311 |
| Publisher version: | https://doi.org/10.1002/epi4.12311 |
| Language: | English |
| Additional information: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | Adherence, cluster‐randomized trial, community, epilepsy, primary care |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10070576 |
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