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Epilepsy care in the southern Caribbean
Gregory Krauss1, Sherry Sandy2, David O C Corbin3
1Department of Neurology, Johns Hopkins University, Meyer 2-147, 600 N Wolfe St., Baltimore, MD 21287, USA.
Epilepsy & Behavior : E&B
|August 28, 2015
Summary
Patients with epilepsy in the southern Caribbean have good access to care but face limited choices for antiepileptic drugs (AEDs). Key gaps include lack of specialists, diagnostic imaging, and EEG services, impacting epilepsy management.
Area of Science:
- Neurology
- Public Health
- Health Systems Research
Background:
- Limited information exists on epilepsy health resources in five southern Caribbean nations: Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia.
- Existing health systems, access to specialized care, antiepileptic drug (AED) availability, and diagnostic capabilities (brain imaging, EEG) for epilepsy patients are poorly documented.
Purpose of the Study:
- To profile the current state of epilepsy care in these five southern Caribbean countries.
- To identify gaps in healthcare services and resources for epilepsy management.
- To inform future policy changes aimed at improving the standard of epilepsy care.
Main Methods:
- Conducted study visits and interviewed diverse healthcare stakeholders, including providers, government officials, and pharmacy staff, across the five countries.
- Administered comprehensive epilepsy care surveys to healthcare providers.
- Gathered data on health system integration, access to specialists, AED formularies, and diagnostic service availability.
Main Results:
- All five countries feature integrated government health systems offering free or subsidized care and AEDs.
- Neurology specialists are present only in Trinidad and Tobago and Barbados.
- Three smaller nations lack public imaging and EEG facilities, with Trinidad experiencing up to year-long MRI/EEG wait times; AED formularies are restricted, particularly in Grenada, Saint Lucia, and Saint Vincent and the Grenadines, with limited access to newer medications.
Conclusions:
- While access to basic healthcare and AEDs is generally good in the southern Caribbean, significant limitations exist in epilepsy care.
- Major challenges include shortages of neurology specialists, inadequate diagnostic imaging and EEG services, financial barriers, long waiting times, and restricted access to a broader range of AEDs.
- Addressing these gaps is crucial for enhancing the quality of epilepsy care and patient outcomes in the region.
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