Telemedicine for Epilepsy Support in Resource-Poor Settings

Abstract

The Problem: Epilepsy is a common disease worldwide causing significant physical and social disability. It is one of the most treatable neurological diseases. Yet, in rural, poorer countries like much of India and Nepal, most people with epilepsy are not undergoing any treatment often because they cannot access doctors.Conventional Approaches: It is being appreciated that perhaps doctors are not the solution and that enabling health workers to treat epilepsy may be better. Few details, however, have been put forward about how that might be achieved.Thinking Differently: Untreated epilepsy should be considered a public health problem like HIV/AIDS, the various steps needed for treatment identified and solutions found.Telemedicine Approaches: Telemedicine might contribute to two steps – diagnosis and review. A tool that enables non-doctors to diagnose episodes as epileptic has been developed as a mobile phone app and has good applicability, sensitivity, and specificity for the diagnosis. There are a number of ways in which the use of phone review or short messaging service can improve management.Conclusion: Telemedicine, as part of a public health program, can potentially help the millions of people in the resource-poor world with untreated epilepsy.

mHealth For Aging China: Opportunities and Challenges

“…The Epilepsy Foundation reports that the epilepsy incidence rate reaches as high as 1/26, 70% of which can be controlled via timely treatment and control. Telemedicine plays an important role in the treatment and follow-up of patients with epilepsy, especially those in remote areas [51]. Epilepsy is a random phenomenon that occurs without warning.…”

<p>Telemedicine in Resource-Limited Setting: Narrative Synthesis of Evidence in Nepalese Context</p>

“…Review identified many reasons behind the lack of accessibility, such as poor communication system, land slide or flash flood during rainy season, etc. In total 20 papers reported the telemedicine features of addressing challenges of geographic remoteness [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] and 11 papers reported time saving [29][30][31][32][33]40,41,[47][48][49][50] character. 4 papers reported communication and transportation 30,32,46,49 related issues.…”

“…Smartphone-based service Patterson et al 2014 43 Epilepsy patients in rural areas in Nepal are mostly deprived of any treatment, because of inadequate doctors and health facilities. Telemedicine program was initiated to overcome these shortcomings.…”

Availability of antiepileptic drugs: Politicians' roles

“…During the past decade or so, many health care professionals and physicians around the world have developed or proposed creative ways to overcome the challenges and to provide better care for patients with epilepsy in resource-limited settings. 4,5 These kinds of actions have often resulted in significant changes regionally. 4 However, poor income, lack of resources, regulatory approval, and high prices are apparently not the only factors that play significant roles in lack of access to AEDs and appropriate epilepsy care.…”