Scaling-up The Competency of Primary Care Workers to Manage Epilepsy by Task-Sharing (STOP-Epilepsy)

Epilepsy is common, stigmatizing and often not treated in resource-limited settings. Failure to treat may result in premature mortality. Treatment in primary healthcare is an option, given the lack of specialists.

We aim to determine if a community-based, primary care initiative leads to improved seizure control, adherence and quality of life in people with epilepsy.

We will develop a perpetuating, virtual research centre comprising clinicians, quantitative and qualitative researchers, engineers, health economists, health communication experts and research trainees from 6 organizations with emphasis on training young physicians for future research. A before-after design at three sites in India, with outcome evaluation by mixed methods will be employed.

A preparatory phase will be followed by community screening to identify cases.

Screen positives will be followed during an 18-month observation phase, and subsequently enter an 18-month interventional phase comprising of -training primary health workers in managing epilepsy, community awareness campaigns, and delivery of a technology-enabled care model. The primary outcome will be change in seizure remission rates between the observation and intervention phase.

Quality of life, medication adherence and feasibility, acceptability and cost-effectiveness of the project will also be assessed. Our learnings will inform policy-makers about the effectiveness of the program.