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Spanos S, Hutchinson K, Ryder T, Rapport F, Goodwin N, Zurynski Y. Integrated Care in Epilepsy Management: A Scoping Review of the Models and Components of Health and Social Care Delivery. Int J Integr Care 2024; 24:18. [PMID: 38463746 PMCID: PMC10921962 DOI: 10.5334/ijic.7659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Epilepsy is the most common neurological condition globally. Integrating health and social care is fundamental in epilepsy management, but the scope of progress in this area is unclear. This scoping review aimed to capture the range and type of integrated care components and models in epilepsy management. Methods Four databases were searched for articles published since 2010 that reported on integrated care in epilepsy. Data were extracted and synthesised into components of integrated care that had been implemented or recommended only. Models of integrated care were identified, and their components tabulated. Results Fifteen common and interrelated components of integrated care emerged that were aligned with four broad areas: healthcare staff and pathways (e.g., epilepsy nurses); tasks and services (e.g., care coordination); education and engagement (e.g., shared decision making); and technology for diagnosis and communication (e.g., telehealth). Twelve models of integrated care were identified; seven were implemented and five were recommended. Discussion There is a growing evidence-base supporting integrated, person-centred epilepsy care, but implementation is challenged by entrenched silos, underdeveloped pathways for care, and deficits in epilepsy education. Conclusion Integrating epilepsy care relies on changes to workforce development and policy frameworks to support whole-of-system vision for improving care.
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Affiliation(s)
- Samantha Spanos
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Karen Hutchinson
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Central Coast Local Health District, Gosford, NSW, Australia
| | - Tayhla Ryder
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- CanTeen Australia, Sydney, Australia
| | - Frances Rapport
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Nicholas Goodwin
- Central Coast Local Health District, Gosford, NSW, Australia
- Central Coast Research Institute for Integrated Care, University of Newcastle, Gosford, NSW, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Rapport F, Hutchinson K, Herkes GK, Bleasel A, Nikpour A, Ryder T, Wong C, Bartley M, Ireland C, Coleman H, Todd L, Groot W, Kerr M, Vagholkar S, Shears G, Braithwaite J. Determining the role and responsibilities of the Australian epilepsy nurse in the management of epilepsy: a study protocol. BMJ Open 2021; 11:e043553. [PMID: 33495260 PMCID: PMC7839898 DOI: 10.1136/bmjopen-2020-043553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Epilepsy is a common neurological condition affecting between 3% and 3.5% of the Australian population at some point in their lifetime. The effective management of chronic and complex conditions such as epilepsy requires person-centred and coordinated care across sectors, from primary to tertiary healthcare. Internationally, epilepsy nurse specialists are frequently identified as playing a vital role in improving the integration of epilepsy care and enhancing patient self-management. This workforce has not been the focus of research in Australia to date. METHODS AND ANALYSIS This multistage mixed-method study examines the role and responsibilities of epilepsy nurses, particularly in primary and community care settings, across Australia, including through the provision of a nurse helpline service. A nationwide sample of 30 epilepsy nurses will be purposively recruited via advertisements distributed by epilepsy organisations and through word-of-mouth snowball sampling. Two stages (1 and 3) consist of a demographic questionnaire and semistructured interviews (individual or group) with epilepsy nurse participants, with the thematic data analysis from this work informing the areas for focus in stage 3. Stage 2 comprises of a retrospective descriptive analysis of phone call data from Epilepsy Action Australia's National Epilepsy Line service to identify types of users, their needs and reasons for using the service, and to characterise the range of activities undertaken by the nurse call takers. ETHICS AND DISSEMINATION Ethics approval for this study was granted by Macquarie University (HREC: 52020668117612). Findings of the study will be published through peer-reviewed journal articles and summary reports to key stakeholders, and disseminated through public forums and academic conference presentations. Study findings will also be communicated to people living with epilepsy and families.
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Affiliation(s)
- Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Karen Hutchinson
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Geoffrey K Herkes
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Andrew Bleasel
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Neurology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Armin Nikpour
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Tayhla Ryder
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Chong Wong
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Neurology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Melissa Bartley
- Department of Neurology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Carol Ireland
- Epilepsy Action Australia, North Ryde, New South Wales, Australia
| | - Honor Coleman
- Epilepsy Foundation, Melbourne, Victoria, Australia
- Melbourne School of Psychological Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Todd
- Epilepsy Action Australia, North Ryde, New South Wales, Australia
| | - Wendy Groot
- Epilepsy Australia, Melbourne, Victoria, Australia
- Epilepsy Tasmania, Launceston, Tasmania, Australia
| | - Mike Kerr
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, Wales, UK
| | - Sanjyot Vagholkar
- MQ Health General Practice, Macquarie University, North Ryde, New South Wales, Australia
| | - Graeme Shears
- Epilepsy Foundation, Melbourne, Victoria, Australia
- Epilepsy Australia, Melbourne, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
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