Description of the referral centers for patients with epilepsy for the implementation of the TeleECHO project in a national institute of health

Abstract

Background: Epilepsy is defined as a neuronal predisposition to generate epileptic seizures; all diagnosed patients must follow the guidelines of the clinical record and have a reference and counter-reference system. Objective: To describe the care centers and characteristics of patients with epilepsy referred to the Comprehensive Epilepsy Care Center 1 (CAIE 1, by its acronym in Spanish) of the National Institute of Neurology and Neurosurgery (INNN, by its acronym in Spanish), as well as evidencing the need for the decentralization of these processes through new technologies and projects such as TeleECHO. Material and methods. An observational, descriptive and cross-sectional study was carried out. Information was obtained through outpatient referral sheets, in order to review the centers, levels of care, place of origin, and reason for the referral of patients with epilepsy to the CAIE 1, from January to December 2017. Patient information sheets without complete data were excluded. Results. Out of 4,866 patients referred to the INNN, 627 patients had epilepsy (mean age of 33.34 ± 15.33 years, 52.8% were women). Most of the referred patients came from private physicians, and primary and tertiary care centers in the Megalopolis (Mexico City, State of Mexico, Hidalgo, Morelos, Querétaro and Tlaxcala). Conclusions. The study allowed us to know and describe the health care centers that refer patients with epilepsy to the CAIE 1 of the INNN in one year. This knowledge will serve to implement the ECHO project, which seeks to improve the referral and counter-referral system and decentralize the care offer for patients with epilepsy. The implementation of said telemedicine program in national centers of most referral aims to reduce the epilepsy treatment gap in Mexico.