Barriers and Facilitators to Accessing Care and Adhering to Medications in People With Epilepsy in India: Healthcare Workers' Perspectives.

Introduction Exploring the barriers and facilitators that people with epilepsy face in accessing care and adhering to medications could enable a better understanding of how India's epilepsy treatment gap could be addressed. Furthermore, there is a paucity of research on the topic, and we could not find any studies exploring these barriers from the perspective of healthcare workers. Aim The study aimed to explore the barriers and facilitators to accessing care and adhering to medications faced by people with epilepsy in India. Methodology Purposive sampling was used to recruit healthcare workers at a private hospital and a non-governmental organization in Pune, India. A total of 13 participants were interviewed, with all of these interviews being audio-recorded. Findings were transcribed and then analyzed by thematic analysis. Findings Several barriers to accessing care were identified, with misconceptions surrounding epilepsy being the most frequently mentioned barrier. Facilitators to accessing care mentioned by participants included higher symptom severity and a higher level of education. Several barriers to medication adherence were discussed, with misconceptions and finances being key themes in participants' responses. Finally, four key themes arose from exploring facilitators to adherence, namely the low cost of medicines, counselling, a good doctor-patient relationship, and a higher education level. Discussion The barriers and facilitators in this study were similar to the barriers and facilitators identified in similar studies. However, some key differences were seen too. For example, this study found financial difficulties to be a key barrier to adherence, but a similar study in South India did not find financial difficulties to be a barrier. Several recommendations can be made based on the findings of this study on how to address India's epilepsy treatment gap. Conclusion People with epilepsy in India face several barriers and facilitators to accessing care and adhering to medications. India's epilepsy treatment gap is a complex and multifactorial issue and will therefore be challenging to address.