Reducing epilepsy diagnostic and treatment gaps: Standardized paediatric epilepsy training courses for health care professionals

Precision medicine in epilepsy: Clinicians' perspectives from an international qualitative study

OBJECTIVE

Precision medicine (PM) is gaining increasing importance in the treatment of rare genetic epilepsies. However, its availability and implementation in clinical practice remain limited. This study explores the barriers and facilitators influencing the implementation of PM for people with epilepsy (PWE).

METHODS

Semistructured interviews were conducted with clinicians involved in epilepsy care for PWE across various global regions. Participants were purposefully selected based on geographical distribution and World Bank income classification. Framework analysis was used to identify key themes.

RESULTS

Sixteen clinicians from six different continents were interviewed. Five key themes emerged. The implementation of PM depends on (1) the personal perspective and experience of health care providers; (2) the attitude of PWE and their caregivers toward PM, and their interaction with clinicians; (3) continuous education of health care providers, formation of expert teams, and generation of robust evidence on PM; (4) multilevel collaboration including patient advocacy groups; and (5) a clear, consistent organizational approach and the development and implementation of standardized guidelines.

SIGNIFICANCE

Clinicians consider PM as transformative for the care for PWE and expect it to redefine standard practice in the near future. Insufficient knowledge is the primary barrier to PM implementation, irrespective of socioeconomic context, highlighting the need for its integration into basic medical training and residency programs. To address inequities, integrated care pathways and standardized guidelines for genetic testing and PM, and the establishment of local PM-focused expert teams are essential to support clinicians in making informed PM decisions.

Report from the child neurology education and training workshop at the International Child Neurology Congress 2024: Expert'saddressing the training gap

This report summarizes the key findings of a workshop undertaken at the International Child Neurology Congress in 2024 by child neurologists with expertise in training education and invested colleagues. The workshop aimed to explore global issues which have impact on access to child neurology training. The major findings supported a great need for more training programs globally, that consensus is needed for the minimum standards of training, and that training programs can be strengthened via global health partnerships especially with collaborations from regions with more available resources. The group concurred that the phenomena of 'neurophobia' amongst general paediatricians and medical trainees, was a reality, and creates barriers both working with paediatric colleagues, as well as recruiting specialists to the field. Optimal teaching practices for child neurology should include the expansion of learning through global partnerships and virtual educational resources. Measures must be put into place for fledgling training programs, to support colleagues in less resourced settings and to avoid their burn-out. Collegial and collaborative work is essential to support the future of child neurology across the globe, both to reach the current capacity needs but also to meet the necessary growth in the field.

Bridging the knowledge gap in epilepsy care: Empowering educators with a cascade training approach

This commentary is on the original article by Gifford et al. on pages 1045–1052 of this issue.