دورية أكاديمية
AB082. Navigating barriers to epilepsy surgery: a national survey of patient and neurologist perspectives.
| العنوان: | AB082. Navigating barriers to epilepsy surgery: a national survey of patient and neurologist perspectives. |
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| المؤلفون: | Bakhshi SK; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Tariq R; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Bajwa MH; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Gauhar F; Vanderbilt University Medical Center, Nashville, TN, USA., Hammad MB; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Akhtar S; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Nasir MB; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan., Mirza FA; Kentucky Neuroscience Institute (KNI), Department of Neurosurgery, University of Kentucky, KY, USA., Enam SA; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. |
| المصدر: | Chinese clinical oncology [Chin Clin Oncol] 2024 Aug; Vol. 13 (Suppl 1), pp. AB082. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101608375 Publication Model: Print Cited Medium: Internet ISSN: 2304-3873 (Electronic) Linking ISSN: 23043865 NLM ISO Abbreviation: Chin Clin Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Hong Kong : AME Publishing Company |
| مواضيع طبية MeSH: | Neurologists* , Epilepsy*/surgery, Humans ; Male ; Female ; Surveys and Questionnaires ; Cross-Sectional Studies ; Adolescent ; Child ; Adult |
| مستخلص: | Background: Potential barriers to epilepsy surgery can be divided into two broad groups: reluctance of patients/caregivers and deficient knowledge of neurologists. Pakistan, in particular, faces an epilepsy surgery treatment gap of 70-94%. This study aimed to assess the knowledge and practice of neurologists and the knowledge of the patients diagnosed with epilepsy to identify the barriers to adequate provision of this modality in Pakistan. Methods: We conducted a cross-sectional study comprising two surveys. Records of patients diagnosed with epilepsy at our hospital during 2.5 years were retrieved from the Neurophysiology database. The second form was designed for neurologists working in Pakistan. The questionnaires were disseminated via email to neurologists and phone calls to patients. Results: In the patients' survey, we obtained 194 responses from caregivers. The median age of patients was 10 years [interquartile range (IQR): 6-14 years]. We found that 74.2% (n=144) of patients were unaware of surgical options in medically refractory epilepsy (MRE). Therefore, most did not comment on it due to the limited information. Forty-eight patients (24.8%) reported more than 1 seizure per month, and 29 (60.4%) were unaware of the surgical treatment. Seizures were disabling in 88% (n=171) of patients. Patients taking more AEDs were significantly more likely to be aware of surgical options (P=0.001). In the survey from neurologists, only 6.6% (n=4) always discussed epilepsy surgery with MRE patients. Around half of the neurologists, 44.3% (n=27), had never referred a patient for epilepsy surgery. However, 95.1% (n=58) were aware of the under-utilization of epilepsy surgery, and 67.2% (n=41) believed that epilepsy surgery is under-recommended. Almost all neurologists (n=60; 98.4%) believe that comprehensive epilepsy treatment centers are required in the country. Conclusions: In our survey, we found a lack of awareness in both patients and neurologists to be a major barrier. This contrasts the literature from developed or high-income countries, where physician awareness seems adequate, and stigmas associated with surgery seem to be the major barrier. Multifaceted approaches catered to local concerns are necessary to address these hindrances. |
| فهرسة مساهمة: | Keywords: Epilepsy surgery; global neurosurgery; knowledge gaps; treatment gaps |
| تواريخ الأحداث: | Date Created: 20240919 Date Completed: 20240919 Latest Revision: 20240919 |
| رمز التحديث: | 20240919 |
| DOI: | 10.21037/cco-24-ab082 |
| PMID: | 39295400 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2304-3873 |
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| DOI: | 10.21037/cco-24-ab082 |