Delivering epilepsy care in low-resource settings: the role of technology

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ABSTRACT

Introduction

The implementation of technology in the field of epileptology has traditionally focused on its use for diagnosis and treatment and has, unsurprisingly, been capital-intensive, making it therefore mainly implementable in advanced high-income countries. Because of technological innovations over the past 20 years there has been almost a paradigm shift, particularly in access to and the potential for implementing relevant technology in lesser developed environments. Nearly 80% of people living with epilepsy live in low and middle-income countries.

Areas covered

The challenge and the purpose of this paper is to discuss how technology can be implemented into lesser-resourced contexts not only cost-effectively but in a cost-saving way while also building capacity and thus sustainability.

Expert opinion

The rate of technological advancement presents the risk of progressive widening of the technology and care gaps between advanced and lesser developed regions. Implementing technology is both about finding relevant appropriate technologies for the individual contexts of a diverse range of countries but also about repurposing low-tech technologies for application in epilepsy care in these areas. Finally exciting advances such as autonomous driving, digital twinning and robotic surgery will likely transform epilepsy care in several lower-resourced settings in the next 5–10 years.

KEYWORDS:

• Epilepsy
• low-resource
• technology
• telehealth
• digital divide
• wearables
• EEG
• cost-effectiveness

Article highlights

• Three-quarters of people globally with epilepsy do not get the treatment they need.

• 70% can be seizure free if properly diagnosed and medically treated.

• Countries should be stratified not only by income but also by available epilepsy resources.

• Implementing technology in low-resource locations can often be a dichotomous choice.

• Telehealth should be used to deliver healthcare and for improving healthcare systems communication, education, public health and other forms of research.

• Smartphone video recordings are extremely valuable for documenting semiology.

• Information from wearables can be very useful in evaluating and monitoring patients.

• Each country will be different and considerations must include assessments of human and technical resources as well as per capita income.

• High-income developed countries must play important roles in assisting low-resourced regions to improve epilepsy care through technological implementations.

• Capacity building and sustainability should be the most important objectives.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.