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Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies

Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by...

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Autores principales: Page, Rupert, Shankar, Rohit, McLean, Brendan N., Hanna, Jane, Newman, Craig
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841122/
https://www.ncbi.nlm.nih.gov/pubmed/29551988
http://dx.doi.org/10.3389/fneur.2018.00099
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author Page, Rupert
Shankar, Rohit
McLean, Brendan N.
Hanna, Jane
Newman, Craig
author_facet Page, Rupert
Shankar, Rohit
McLean, Brendan N.
Hanna, Jane
Newman, Craig
author_sort Page, Rupert
collection PubMed
description Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by the circumstances in which many such patients present. Despite increasing recognition of the importance of earlier identification of those at risk, there is little or no improvement in outcomes over more than 30 years. Despite ever increasing sophistication of drug development and delivery, there has been no meaningful improvement in 1-year seizure freedom rates over this time. However, in the last few years, there has been an increase in patient-triggered interventions based on automated monitoring of indicators and risk factors facilitated by technological advances. The opportunities such approaches provide will only be realized if accompanied by current working practice changes. Replacing traditional follow-up appointments at arbitrary intervals with dynamic interventions, remotely and at the point and place of need provides a better chance of a substantial reduction in seizures for people with epilepsy. Properly implemented, electronic platforms can offer new opportunities to provide expert advice and management from first presentation thus improving outcomes. This perspective paper provides and proposes an informed critical opinion built on current evidence base of an outline techno-therapeutic approach to harnesses these technologies. This conceptual framework is generic, rather than tied to a specific product or solution, and the same generalized approach could be beneficially applied to other long-term conditions.
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spelling pubmed-58411222018-03-16 Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies Page, Rupert Shankar, Rohit McLean, Brendan N. Hanna, Jane Newman, Craig Front Neurol Neuroscience Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by the circumstances in which many such patients present. Despite increasing recognition of the importance of earlier identification of those at risk, there is little or no improvement in outcomes over more than 30 years. Despite ever increasing sophistication of drug development and delivery, there has been no meaningful improvement in 1-year seizure freedom rates over this time. However, in the last few years, there has been an increase in patient-triggered interventions based on automated monitoring of indicators and risk factors facilitated by technological advances. The opportunities such approaches provide will only be realized if accompanied by current working practice changes. Replacing traditional follow-up appointments at arbitrary intervals with dynamic interventions, remotely and at the point and place of need provides a better chance of a substantial reduction in seizures for people with epilepsy. Properly implemented, electronic platforms can offer new opportunities to provide expert advice and management from first presentation thus improving outcomes. This perspective paper provides and proposes an informed critical opinion built on current evidence base of an outline techno-therapeutic approach to harnesses these technologies. This conceptual framework is generic, rather than tied to a specific product or solution, and the same generalized approach could be beneficially applied to other long-term conditions. Frontiers Media S.A. 2018-03-02 /pmc/articles/PMC5841122/ /pubmed/29551988 http://dx.doi.org/10.3389/fneur.2018.00099 Text en Copyright © 2018 Page, Shankar, McLean, Hanna and Newman. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Page, Rupert
Shankar, Rohit
McLean, Brendan N.
Hanna, Jane
Newman, Craig
Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title_full Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title_fullStr Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title_full_unstemmed Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title_short Digital Care in Epilepsy: A Conceptual Framework for Technological Therapies
title_sort digital care in epilepsy: a conceptual framework for technological therapies
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841122/
https://www.ncbi.nlm.nih.gov/pubmed/29551988
http://dx.doi.org/10.3389/fneur.2018.00099
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