Care delivery and self management strategies for adults with epilepsy

Abstract

BackgroundResearchers have criticised epilepsy care for adults for its lack of impact, stimulating the development of various service models and strategies to respond to perceived inadequacies. ObjectivesTo assess the effects of any specialised or dedicated intervention beyond that of usual care in adults with epilepsy. Search methodsFor the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (9 December 2013), the Cochrane

A national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths

“…The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE. 38 Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy-related deaths occurred in the two most deprived SIMD quintiles. This finding is also seen in many other conditions in Scotland, 40 and illustrates how widespread the problem of social deprivation is, suggesting that generic strategies for improving social mobility and support could be as effective for epilepsy as for other conditions.…”

“…Health care services may also need to be re‐evaluated to facilitate acute seizure‐ and epilepsy‐related hospital admissions translating into outpatient neurology care, as we demonstrate a disparity between these areas. The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE 38 . Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy‐related deaths occurred in the two most deprived SIMD quintiles.…”

A national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths

“…The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE. 38 Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy-related deaths occurred in the two most deprived SIMD quintiles. This finding is also seen in many other conditions in Scotland, 40 and illustrates how widespread the problem of social deprivation is, suggesting that generic strategies for improving social mobility and support could be as effective for epilepsy as for other conditions.…”

“…Health care services may also need to be re‐evaluated to facilitate acute seizure‐ and epilepsy‐related hospital admissions translating into outpatient neurology care, as we demonstrate a disparity between these areas. The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE 38 . Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy‐related deaths occurred in the two most deprived SIMD quintiles.…”

Barriers and facilitators to implementation of epilepsy self-management programs: a systematic review using qualitative evidence synthesis methods

“…Within these themes, facilitators and barriers were identified at the person, program, and system-levels. Our findings add to the literature as recent systematic reviews on self-management interventions for adults with epilepsy [11,57,58] have not focused on facilitators and barriers to intervention implementation and adoption (Table 6).…”

Process evaluation of a multi-component self-management intervention for adults with epilepsy (ZMILE study)

“…It is difficult to compare these results with other self-management interventions for people with epilepsy as process evaluations in this field are lacking [16]. When compared with the 'Plan Ahead 'intervention, a comparable self-management intervention for stroke patients and their partners [25], we find similarities and differences.…”

A national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths

“…The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE. 38 Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy-related deaths occurred in the two most deprived SIMD quintiles. This finding is also seen in many other conditions in Scotland, 40 and illustrates how widespread the problem of social deprivation is, suggesting that generic strategies for improving social mobility and support could be as effective for epilepsy as for other conditions.…”

“…Health care services may also need to be re‐evaluated to facilitate acute seizure‐ and epilepsy‐related hospital admissions translating into outpatient neurology care, as we demonstrate a disparity between these areas. The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE 38 . Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy‐related deaths occurred in the two most deprived SIMD quintiles.…”

Barriers and facilitators to implementation of epilepsy self-management programs: a systematic review using qualitative evidence synthesis methods

“…Within these themes, facilitators and barriers were identified at the person, program, and system-levels. Our findings add to the literature as recent systematic reviews on self-management interventions for adults with epilepsy [11,57,58] have not focused on facilitators and barriers to intervention implementation and adoption (Table 6).…”

Process evaluation of a multi-component self-management intervention for adults with epilepsy (ZMILE study)

“…It is difficult to compare these results with other self-management interventions for people with epilepsy as process evaluations in this field are lacking [16]. When compared with the 'Plan Ahead 'intervention, a comparable self-management intervention for stroke patients and their partners [25], we find similarities and differences.…”

A national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths

“…The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE. 38 Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy-related deaths occurred in the two most deprived SIMD quintiles. This finding is also seen in many other conditions in Scotland, 40 and illustrates how widespread the problem of social deprivation is, suggesting that generic strategies for improving social mobility and support could be as effective for epilepsy as for other conditions.…”

“…Health care services may also need to be re‐evaluated to facilitate acute seizure‐ and epilepsy‐related hospital admissions translating into outpatient neurology care, as we demonstrate a disparity between these areas. The reasons for this remain unclear and require further investigation, particularly as outpatient neurology care is related to improved clinical outcomes for PWE 38 . Furthermore, excess mortality in PWE has been linked to increased social deprivation in England, 39 and we demonstrate similar trends in Scotland, where the majority of epilepsy‐related deaths occurred in the two most deprived SIMD quintiles.…”

Barriers and facilitators to implementation of epilepsy self-management programs: a systematic review using qualitative evidence synthesis methods

“…Within these themes, facilitators and barriers were identified at the person, program, and system-levels. Our findings add to the literature as recent systematic reviews on self-management interventions for adults with epilepsy [11,57,58] have not focused on facilitators and barriers to intervention implementation and adoption (Table 6).…”

Process evaluation of a multi-component self-management intervention for adults with epilepsy (ZMILE study)

“…It is difficult to compare these results with other self-management interventions for people with epilepsy as process evaluations in this field are lacking [16]. When compared with the 'Plan Ahead 'intervention, a comparable self-management intervention for stroke patients and their partners [25], we find similarities and differences.…”