The seizure recurrence rate in epileptic patients following universal health coverage: A time-series study

Abstract

Background: Epileptic patients (EP) should be free of seizure recurrence (SR). Universal Health Coverage (UHC) was implemented in 2005 in Iran, aiming to tackle obstacles in front of health services’ utilization. This study was done in order to assess the SR rate in EP after UHC implementation. Methods: This study was a prospective time series that was done in rural areas of Falavarjan district in Isfahan province in central Iran from March 2016 to March 2017. 245 patients who suffering from any type of epilepsy and whom epilepsy confirmed by a neurologist, registered. All epileptic patients monitored continuously every month through the study, and the signs or symptoms attributed to the suspected seizure were assessed and referred to a physician for additional assessment and consultation to improve treatment compliance. The patients’ data about their demographic characteristics, type of epilepsy, any SR attack, and their risk factors were gathered from their self-files based on the checklists. Results: Despite treatment schedules that were carried out for all EPs, during one year follow up, however, 37 (15.1%) patients displayed SR attacks. 19 (7.75%) patients who suffered RS were male with the mean age of 40 ± 13.5 years, without gender statistical difference (P=0.810). In patients who had RS, the main causes of lacking adherence to their treatment were forgetting to take medicines in 10 (55.6%), poverty in 3 (16.7%), and lacking motivation in 2 (11.1%) EPs. Conclusion: Following UHC implementation in the primary health delivery system, that neuropsychiatric health packages were integrated, the incidence rate of SR attack in EPs was low.