Evidence map›Paper›PMID 36213959›Full record

Trial reportEpilepsia open2022

A cluster-randomized trial comparing home-based primary health care and usual clinic care for epilepsy in a resource-limited country.

Gagandeep Singh, Suman Sharma, Namita Bansal, Meenakshi Sharma, Anurag Chowdhury, Sarit Sharma, Rajinder K Bansal, Jatinder S Goraya, Raj K Setia, Birinder S Paul and 1 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Epilepsia open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 4 countries.

Gagandeep SinghResearch & Development Unit, Dayanand Medical College, Ludhiana, India.ORCID 0000-0001-6661-3553
Suman SharmaResearch & Development Unit, Dayanand Medical College, Ludhiana, India.
Namita BansalResearch & Development Unit, Dayanand Medical College, Ludhiana, India.
Meenakshi SharmaNon-communicable Diseases Division, Indian Council of Medical Research, New Delhi, India.
Anurag ChowdhuryDepartment of Social & Preventive Medicine, Dayanand Medical College, Ludhiana, India.
Sarit SharmaDepartment of Social & Preventive Medicine, Dayanand Medical College, Ludhiana, India.
Rajinder K BansalDepartment of Neurology, Dayanand Medical College, Ludhiana, India.
Jatinder S GorayaDepartment of Paediatrics, Dayanand Medical College, Ludhiana, India.ORCID 0000-0002-0906-0267
Raj K SetiaPunjab Remote Sensing Centre, Ludhiana, India.
Birinder S PaulDepartment of Neurology, Dayanand Medical College, Ludhiana, India.
Josemir W SanderUCL Queen Square Institute of Neurology, London WC1N 3BG, London, UK.ORCID 0000-0001-6041-9661
Dayanand Medical College & Hospital · INIndian Council of Medical Research · INPunjab Remote Sensing Centre · INSichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo ascertain whether home-based care with community and primary healthcare workers' support improves adherence to antiseizure medications, seizure control, and quality of life over routine clinic-based care in community samples of people with epilepsy in a resource-poor country.

methodsParticipants included consenting individuals with active epilepsy identified in a population survey in impoverished communities. The intervention included antiseizure medication provision, adherence reinforcement and epilepsy self- and stigma management guidance provided by a primary health care-equivalent worker. We compared the intervention group to a routine clinic-based care group in a cluster-randomized trial lasting 24 months. The primary outcome was antiseizure medication adherence, appraised from monthly pill counts. Seizure outcomes were assessed by monthly seizure aggregates and time to first seizure and impact by the Personal Impact of Epilepsy scale.

resultsEnrolment began on September 25, 2017 and was complete by July 24, 2018. Twenty-four clusters, each comprising ten people with epilepsy, were randomized to either home- or clinic-care. Home-care recipients were more likely to have used up their monthly-dispensed epilepsy medicine stock (regression coefficient: 0.585; 95% confidence intervals, 0.289-0.881; P = 0.001) and had fewer seizures (regression coefficient: -2.060; 95%CI, -3.335 to -0.785; P = 0.002). More people from clinic-care (n = 44; 37%) than home-care (n = 23; 19%) exited the trial (P = 0.003). The time to first seizure, adverse effects and the personal impact of epilepsy were similar in the two arms. SIGNIFICANCE: Home care for epilepsy compared to clinic care in resource-limited communities improves medication adherence and seizure outcomes and reduces the secondary epilepsy treatment gap.

Indexed as

EpilepsyHome Care ServicesHumansPrimary Health CareQuality of LifeSeizuresadherencelow- and middle-income countriespersonal impactsecondary treatment gapseizure control

Identifiers

PMID36213959
PMCPMC9712458
OpenAlexW4304117608

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.