Integrated care in epilepsy management: A scoping review of the models and components of health and social care delivery

Why integrated care?

Managing the physical and psychosocial impacts of epilepsy requires ongoing health and social care1. Epilepsy care lacks continuity and standardisation, impacting care access, efficiency, and experience for people with epilepsy and their families2.

Research aims

Integrated epilepsy care approaches are proliferating globally. This work aimed to examine the core care components of these approaches and the factors that
influence their implementation.

Research methods

1. Searched PubMed, Web of Science, Medline & Embase

2. Selected articles reporting on integrated epilepsy care components or models

3. Extracted data on components, models, and implementation factors

4. Synthesised common categories of care components

Core care components

HEALTHCARE STAFF & PATHWAYS

1. Multidisciplinary teams
4. Epilepsy nurses
3. Cross-sector collaboration
2. Clinical guidelines

TASKS & SERVICES

5. Psychosocial services
7. Care management planning
8. Transition to adult services
9. Surgical evaluation
6. Care coordination

EDUCATION & ENGAGEMENT

10. Person-centred education
11. Shared decision-making
12. Provider education

TECHNOLOGY & TOOLS

13. Telehealth services
14. Digital health tools

15. Shared medical records

Models of care

- Twelve models of integrated care were identified;none included all 15 core care components, and only 7 had been implemented.
- Most widely implemented components were multidisciplinary teams, cross-sector collaboration, and care management planning.
- Components omitted from models of care were paediatric to adult transition services, digital health support tools, and surgical evaluation services.

Implementation factors

HEALTH SYSTEM BARRIERS

• Cross-sector communication difficulties
• Information sharing limitations
• Lack of role clarity for healthcare professionals

HEALTH SYSTEM ENABLERS

• Shared technologies available
• Standardised clinical practice guideline use
• Healthcare professional education & training

Where to from here?

For integrated care approaches to be sustainable and comprehensive, they should prioritise shared crosssectoral goals, interdisciplinary education, and
developing policy and funding frameworks that support cross-boundary collaboration.

Spanos S | Hutchinson K | Goodwin N | Rapport F | Zurynski Y

References

1 Higgins A, Downes C, Varley J et al. Epilepsy Behav.
2018; 85: 85-94.
2 Hutchinson K, Herkes G, Shih P et al. Epilepsy
Behav. 2020; 111.

Contact information

Dr Samantha Spanos
samantha.spanos@mq.edu.au