Tomlins Jack, Pearson Stephen
Critical Care, King's College Hospital National Health Service (NHS) Foundation Trust, London, GBR.
Academic Centre for International Students, Faculty of Arts and Humanities, University of Southampton, Southampton, GBR.
Cureus. 2024 Oct 25;16(10):e72393. doi: 10.7759/cureus.72393. eCollection 2024 Oct.
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.
引言
探究癫痫患者在获得治疗和坚持服药方面面临的障碍及促进因素，有助于更好地理解如何解决印度的癫痫治疗缺口问题。此外，关于该主题的研究较少，我们未找到任何从医护人员角度探究这些障碍的研究。
目的
本研究旨在探究印度癫痫患者在获得治疗和坚持服药方面面临的障碍及促进因素。
方法
采用目的抽样法，在印度浦那的一家私立医院和一个非政府组织招募医护人员。共采访了13名参与者，所有采访均进行了录音。对访谈结果进行转录，然后通过主题分析进行分析。
结果
确定了获得治疗的几个障碍，其中围绕癫痫的误解是最常被提及的障碍。参与者提到的获得治疗的促进因素包括症状严重程度较高和教育水平较高。讨论了药物依从性的几个障碍，误解和经济因素是参与者回答中的关键主题。最后，在探究依从性的促进因素时出现了四个关键主题，即药品成本低、咨询、良好的医患关系和较高的教育水平。
讨论
本研究中的障碍和促进因素与类似研究中确定的障碍和促进因素相似。然而，也存在一些关键差异。例如，本研究发现经济困难是依从性的关键障碍，但印度南部的一项类似研究未发现经济困难是障碍。基于本研究的结果，可以就如何解决印度的癫痫治疗缺口提出一些建议。
结论
印度的癫痫患者在获得治疗和坚持服药方面面临若干障碍和促进因素。印度的癫痫治疗缺口是一个复杂的多因素问题，因此解决起来具有挑战性。
