Epileptic seeking

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Try out PMC Labs and tell us what you think. Learn More. Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants.

Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predeed, pretested, semi-structured proforma.

The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A ificant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas.

District care model of epilepsy was proposed in the recommendation. In the present world of ours, non-communicable diseases are becoming a lot more important health concerns both in the developing and developed countries Neurological diseases are a leading cause of disability and their treatment entails prolonged hospitalization with a commensurate financial toll. Epilepsy is an important neurological disorder prevalent in India. Social stigma associated with the disease greatly modifies the healthcare-seeking behavior. Social beliefs play a pivotal role in this regard. In a country like India where the population is so diverse in every regard, starting from education and per capita income to beliefs in healthcare-seeking behavior in epilepsy is quite varied, ranging from modern allopathic treatment to traditional methods like witchcraft.

In India, the treatment gap varied between In this present scenario, where epilepsy has already been declared as a public health problem 5 by the World Health Organization WHO and the International League Against Epilepsy ILAEand the situation being considerably grave in India, this study was planned in the Department of Neuromedicine, Medical College, Kolkata, which is a premier institution and hospital in India and caters to a huge of patients from all over the state and some neighboring states, regularly, with the objective of assessing the healthcare-seeking behavior and its determinants among the epilepsy patients.

Epileptic seeking

The present observational, descriptive, cross-sectional, hospital-based study was conducted in the outpatient department OPD of the Department of Neuromedicine of the Medical College, Kolkata, situated in Kolkata, during the period from October to Juneamong the diagnosed epilepsy patients attending the said OPD. As the study period was nine months, the expected attendance in this period came up to The study sample was selected using the systematic random sampling technique, following the inclusion criteria of the study, and entry of the study subject was continued until the total desired sample size of was arrived at.

Ethical clearance and informed consent of the patients was taken before the study. Techniques followed were interview of the patients and attending caregiver, with the predeed, pretested semi-structured proforma and analysis of the records available with the patients. Analysis was done the using Epi info 3. Among the epilepsy patients, the majority of the study population belonged to the age group of 16 to 30 years The mean age of the study population was One hundred and forty-three Regarding the education status, A majority of the study population were unskilled labor The mean per capita income for the total study population, males and females, was seen to be The study population of A majority Regarding the source of the first healthcare-seeking after the onset of seizure, Only 1.

Females had more preference for homeopathy and traditional medicines than allopathic ones compared to males, [ Table 1 ]. In All the female patients had sought care within 24 hours of the onset of seizure [ Table 2 ]. The actual time gap between the onset of seizure and starting of Antiepileptic drug AED was less than 24 hours in The mean time gap between the onset of seizure and the start of AED for the study population was 2.

The first AED was taken from the general practitioner by A study population of 0.

Epileptic seeking

However, The mean gap was Among the study population, sought allopathy treatment initially, whereas, 58 opted for treatment other than allopathy. The other variables did not show a statistically ificant relationship [ Table 4 ]. Relationship of some sociodemographic variables with the initial healthcare. The present study observed that a majority of the study population had sought care almost simultaneously with the onset of seizures, with very little delay.

Different studies 6 — 8 had shown that the people with epilepsy were not taking AED due to non-availability and non-accessibility of AEDs in the vicinity. However, the other important reasons were the preference of the people for treatment from traditional practitioners, although AED was accessible, as highlighted by these studies.

These findings were similar to the findings of Bhattacharya et al. However, Singh et al.

Epileptic seeking

It should be mentioned here that the quacks were much less popular in rural West Bengal compared to the d medical practitioners, as observed by Pal et al. Although considering the time gap between the onset of epilepsy and first search for healthcare, the present study observed that No studies were available to corroborate the present study findings. The mean time gap between the onset of seizure and the start of AED was 2.

In their study Thomas et al. The delay in treatment was attributed to the use of traditional medicines, non-disabling nature of the seizures, and different diagnosis. Less time gap in the present study might be due to the fact that the study population did not prefer traditional medicines as the initial mode of treatment.

Source of the first AED for the study population widely varied according to their residence in the present study. The people with rural residence received AED mainly from the general practioners However, the urban people consulted neurologists This wide variation was probably due to the availability of neurologists, and the awareness and affordability of the urban people. Similar findings of the rural—urban difference was also observed by Malmgren et al. Bhattacharya et al. On analyzing the relationship of some sociodemographic variables with the initial healthcare-seeking behavior, no ificant association was observed in the case of sex, types of seizure, and educational status of the epilepsy patients, and their head of the family, with the initial healthcare-seeking behavior.

However, a ificant association was observed in the case of the residence and socioeconomic status of the family. Pal et al. The present study revealed that the majority of the study population was in the age group of 16 — 30 years; they were Hindu males, and came from urban areas.

A majority of the study population had completed primary education, were unskilled laborers, and unemployed.

Epileptic seeking

The majority opted for allopathic medicine and causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and non-availability of allopath doctors at the time of need. A ificant association existed between rural residence and the low social status of the patients with care-seeking from sources other than allopaths. Most of the patients started AED almost after the onset of seizure, for AEDs preferred neurologists in urban areas, whereas, general practitioners in rural areas. Therefore, the major chunk of cases at these levels, are presently not diagnosed.

These patients, if they get their treatment in the Primary Health Centre PHC or Community Health Center according to the vicinity, a substantial financial burden on epilepsy patients can be reduced. Neurologists in present India are available mainly in the Metros and tertiary care hospitals. If a neurologist can be kept as a Nodal neurologist for a district, as suggested by the district model for the epilepsy control program by Gourie Devi et al.

This referral chain, if established, can allow the follow-up of the epilepsy patients in the local healthcare facility only, and simultaneously allow the referral of difficult-to-treat epilepsy cases to the care of a neurologist.

Epileptic seeking

PHC medical officers in turn can train the peripheral health workers regarding case detection of epilepsy, thus reducing the treatment delay. The peripheral health workers can also play a pivotal role in increasing community awareness regarding epilepsy.

Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology InformationU. Indian J Community Med. Author information Article notes Copyright and information Disclaimer.

Epileptic seeking

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Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, kolkata