title: Epilepsy in Ireland: towards the primary-tertiary care continuum.
abstract: BACKGROUND
  Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings.
  
  
  OBJECTIVE
  To explore the interface between primary care and specialist epilepsy services in Ireland.
  
  
  METHODS
  Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland.
  
  
  RESULTS
  There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT).
  
  
  CONCLUSIONS
  Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system.
authors.affiliation: Epilepsy Programme, Beaumont Hospital, Dublin 9, Ireland. Jarlathvarley@beaumont.ie
authors.forename: Jarlath
authors.initials: J
authors.lastname: Varley
authors.forename: Norman
authors.initials: N
authors.lastname: Delanty
authors.forename: Charles
authors.initials: C
authors.lastname: Normand
authors.forename: Imelda
authors.initials: I
authors.lastname: Coyne
authors.forename: Louise
authors.initials: L
authors.lastname: McQuaid
authors.forename: Claire
authors.initials: C
authors.lastname: Collins
authors.forename: Michael
authors.initials: M
authors.lastname: Boland
authors.forename: Jane
authors.initials: J
authors.lastname: Grimson
authors.forename: Mary
authors.initials: M
authors.lastname: Fitzsimons
mesh_terms: D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D019033:Delivery of Health Care, Integrated; D019468:Disease Management; D004827:Epilepsy / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods*; D013038:Specialization; D013041:Specialties, Nursing; D016896:Treatment Outcome