title: Patient perceptions of the referral of older adults to an epilepsy clinic: do patients and professionals agree who should be referred to a specialist?
abstract: The aim of this study was to establish whether older patients concurred with previously reported staff perceptions of why older adults may be underrepresented in epilepsy clinics. Fifteen interviews with older patients provided support for four of seven key factors previously suggested by professionals as leading to underreferral of older adults: unclear referral pathway, complex differential diagnosis, gaps in referrer knowledge, and the length of time since onset. However, the patients interviewed did not report that patient difficulties accessing the hospital, patient reluctance to attend clinics, or the particular characteristics of older patients (knowledge, awareness, and willingness to ask for help) made it less likely that older adults would want to attend a specialist epilepsy clinic. While recognizing the limitations of the study, particularly in relation to the number of participants, we believe that it provides valuable further insights into the age-bias apparent in referral patterns to specialist epilepsy services. Of particular concern are professional assumptions regarding older patients' willingness to attend appointments and about the impact of seizures on the life of an older adult.
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK. Electronic address: l.blank@sheffield.ac.uk.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Blank
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK. Electronic address: w.o.baird@sheffield.ac.uk.
authors.forename: Wendy
authors.initials: W
authors.lastname: Baird
authors.affiliation: Academic Neurology Unit, University of Sheffield, Sheffield, UK. Electronic address: Markus.Reuber@sth.nhs.uk.
authors.forename: Markus
authors.initials: M
authors.lastname: Reuber
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010465:Perception; D012017:Referral and Consultation
keywords: Elderly; Epidemiology; Epilepsy; Geriatrics; Health care disparities; Qualitative