The operational model of a network for managing patients with convulsive epilepsy in rural West China.
OBJECTIVE
To establish an operational model of a network for managing patients with convulsive epilepsy in rural areas of West China.


METHODS
The network is under unified leadership of the public health administration departments, who liaised with medical institutions and disease control and prevention organizations to foster local communities to participate. Patients with convulsive epilepsy were treated with phenobarbital. Trained local primary health care physicians carried out screening, treatment, and follow-up. Political, financial, and technological support was incrementally provided through the network. Efficacy was assessed as the percentage reduction in seizure frequency and the retention of patients on treatment.


RESULTS
Two thousand five hundred fourteen patients with active convulsive epilepsy were enrolled. After more than 1 year of treatment, 78.4% of the patients had a 50% or greater reduction in seizure frequency and 43.3% remained seizure free. Probability of retention was 85.8% at 750 days. Nearly 20% patients withdrew from the project, and most of them migrated out of the study areas. Some regular training and educational programs were also carried out.


CONCLUSIONS
This pragmatic procedure suggests that the network could be suitable for managing convulsive epilepsy in resource-poor regions. Such a network could depend on existing primary health services to ensure its sustainability.
Liu
Ling
L
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Zhang
Qin
Q
Yao
Zhiping
Z
Wang
Xiaowen
X
Zhu
Cairong
C
Gao
Yali
Y
He
Jun
J
Wang
Zhuo
Z
Zhang
Ningmei
N
D'Souza
Wendyl
W
Zhou
Dong
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003153:Community Health Services / Q000379:methods*; D019058:Community Networks; D004829:Epilepsy, Generalized / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010634:Phenobarbital / Q000627:therapeutic use*; D011635:Public Health Administration / Q000193:education / Q000379:methods; D012189:Retrospective Studies; D012424:Rural Population; D055815:Young Adult
D000927:Anticonvulsants; D010634:Phenobarbital