Doctor-patient communication in epilepsy care: An integrative review

Effective doctor-patient communication has been reported to transform the experiences of people with epilepsy and their families in healthcare settings. An integrative review was conducted to integrate findings across existing evidence to provide a comprehensive understanding of doctor-patient communication in epilepsy care. Databases searched were Medline, Embase, Web of Science, PsycInfo, CINAHL, Cochrane and Global Health. Articles assessing doctor-patient communication among adults with epilepsy in outpatient clinic settings as primary outcome were identified. The methodological quality of included studies was evaluated using the mixed-method appraisal tool (MMAT). Thematic analysis was conducted for this synthesis. About 47 full-text records were identified, and the final review included 18 studies. Themes identified are Emotional and relational dynamics, fragmentation in communication across epilepsy care trajectory, cultural responsiveness and context-sensitive engagement, missed opportunities for doctor-patient collaboration, and empowering patient-centered care through supportive strategies. The findings highlight that the quality of doctor-patient communication in epilepsy care depends on the content of information exchange, and complexities inherent in explaining the condition. Effective communication depends on positive interpersonal perception and active patient participation in communication. Quality care also requires adequate time allocation by doctors in discussions and addressing the patients' sociocultural context and stigma. Future studies should be directed toward building theoretical models that explain how underlying social processes shape communication practices and guide the design of effective, context-specific interventions.