Mayuri Mahendran1, Kathy N Speechley2, Elysa Widjaja3. 1. Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada. 2. Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Children's Hospital, 800 Commissioners Road East, Rm B1-437, London, Ontario N6A 5W9, Canada. 3. Division of Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address: elysa.widjaja@sickkids.ca.
Abstract
OBJECTIVE: Patients with epilepsy (PWE) are more likely to have unmet healthcare needs than the general population. This systematic review assessed the reasons for unmet needs in PWE. METHODS: Medline, Embase, PsycINFO, Cochrane, and Web of Science databases were searched using keywords relating to unmet healthcare needs, treatment barriers, and access to care. The search included all countries, adult and pediatric populations, survey and qualitative studies, but excluded non-English articles and articles published before 2001. Reasons for unmet needs were extracted. RESULTS: Nineteen survey and 22 qualitative studies were included. Three survey and five qualitative studies excluded patients with comorbidities. There were twice as many studies on unmet mental healthcare needs than unmet physical care needs in PWE. Poor availability of health services, accessibility issues, and lack of health information contributed to unmet needs in both Western and developing countries. Lack of health services, long wait lists, uncoordinated care, and difficulty getting needed health information were prevalent in the United States (US) as well as countries with a universal healthcare system. However, unmet needs due to costs of care were reported more commonly in studies from the US. SIGNIFICANCE: This systematic review identified reasons for unmet needs in PWE across different countries, which will inform specific interventions required to address these unmet needs. Unmet needs may have been underestimated due to exclusion of PWE with comorbidities in some studies. Additional studies are needed to understand the contribution of comorbidities on unmet needs and their interaction with caregiver and family factors.
OBJECTIVE:Patients with epilepsy (PWE) are more likely to have unmet healthcare needs than the general population. This systematic review assessed the reasons for unmet needs in PWE. METHODS: Medline, Embase, PsycINFO, Cochrane, and Web of Science databases were searched using keywords relating to unmet healthcare needs, treatment barriers, and access to care. The search included all countries, adult and pediatric populations, survey and qualitative studies, but excluded non-English articles and articles published before 2001. Reasons for unmet needs were extracted. RESULTS: Nineteen survey and 22 qualitative studies were included. Three survey and five qualitative studies excluded patients with comorbidities. There were twice as many studies on unmet mental healthcare needs than unmet physical care needs in PWE. Poor availability of health services, accessibility issues, and lack of health information contributed to unmet needs in both Western and developing countries. Lack of health services, long wait lists, uncoordinated care, and difficulty getting needed health information were prevalent in the United States (US) as well as countries with a universal healthcare system. However, unmet needs due to costs of care were reported more commonly in studies from the US. SIGNIFICANCE: This systematic review identified reasons for unmet needs in PWE across different countries, which will inform specific interventions required to address these unmet needs. Unmet needs may have been underestimated due to exclusion of PWE with comorbidities in some studies. Additional studies are needed to understand the contribution of comorbidities on unmet needs and their interaction with caregiver and family factors.
Authors: David J Thurman; Charles E Begley; Arturo Carpio; Sandra Helmers; Dale C Hesdorffer; Jie Mu; Kamadore Touré; Karen L Parko; Charles R Newton Journal: Epilepsia Date: 2018-04-10 Impact factor: 5.864
Authors: Sophie D Bennett; J Helen Cross; Anna E Coughtrey; Isobel Heyman; Tamsin Ford; Bruce Chorpita; Rona Moss-Morris; Sarah Byford; Emma Dalrymple; Colin Reilly; Terence Stephenson; Caroline Doré; Sophia Varadkar; James Blackstone; Kashfia Chowdhury; Poushali Ganguli; Liz Deane; Roz Shafran Journal: Trials Date: 2021-02-11 Impact factor: 2.279