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. 2023 Dec;13(6):e200211.
doi: 10.1212/CPJ.0000000000200211. Epub 2023 Oct 2.

Inequities in Epilepsy: A Scoping Review

Merhawit Ghebrehiwet  1 , Katherine Cox  1 , Danya Nees  1 , Bryan Dunford  1 , Samuel M Jacobsen  1 , Rigel Bacani  1 , Matt Vassar  1
Affiliations

Inequities in Epilepsy: A Scoping Review

Merhawit Ghebrehiwet et al. Neurol Clin Pract. 2023 Dec.

Abstract

Objectives: The objective of this study was to complete a scoping review of current literature surrounding health inequities in epilepsy while providing recommendations for future research.

Methods: During July 2022, we searched MEDLINE and Ovid Embase to find published articles pertaining to epilepsy and health inequities. Initially, authors received training. Authors then screened, and data were extracted in a masked duplicate manner. Studies published within the time frame of 2011-2021 in all countries were deemed appropriate. We screened 5,325 studies for titles and abstracts and then 56 studies for full text. We evaluated the inequities of race/ethnicity, sex or gender, income, occupation status, education level, under-resourced/rural population, and LGBTQ+. To summarize the data and descriptive statistics of our study, we used Stata 17.0 (StataCorp, LLC, College Station, TX).

Results: We obtained a sample size of 45 studies for study inclusion. The most reported health inequities were income (18/45, 40.0%), under-resourced/rural population (15/45, 33.3%), and race/ethnicity (15/45, 33.3%). The least reported health inequity was LGBTQ+ (0/45, 0.0%).

Discussion: The findings of our study suggest that gaps exist in literature concerning epilepsy and inequities. The inequities of income status, under-resourced/rural population, and race/ethnicity were examined the most, while LGBTQ+, occupation status, and sex or gender were examined the least. With the ultimate goal of more equitable and patient-centered care in mind, it is vital that future studies endeavor to fill in these determined gaps.

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Conflict of interest statement

M. Vassar reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences–all outside of the present work. All other authors have nothing to report. Full disclosure form information provided by the authors is available with the full text of this article at TAKE-HOME POINTS→ In patients with epilepsy, what are the inequities that have been researched and are there any gaps in research?→ Our scoping review examining 45 studies determined gaps exist within current published literature. The inequities of income status, under-resourced/rural population, and race/ethnicities were examined more than LGBTQ+, occupation status, and sex or gender.→ Our study demonstrates gaps are evident in present literature evaluating inequities in epilepsy. Future research should aim to fill these gaps, so patients can achieve more equitable and inclusive care.Neurology.org/cp.

Figures

Figure 1
Figure 1. PRISMA Flow Diagram
This flow diagram displays exclusion rationales throughout the screening and data extraction processes. PRISMA = Preferred Reporting Items for Systematic reviews and Meta Analyses.
Figure 2
Figure 2. Frequency of Inequities Examined
This figure demonstrates the frequency in which inequities were reported.
Figure 3
Figure 3. Frequency of Inequities Examined Over Time
This figure describes the changes in reporting frequency for the 3 most reported inequities over the years.
See this image and copyright information in PMC

References

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    1. Epilepsy. Accessed July 8, 2022. who.int/news-room/fact-sheets/detail/epilepsy.
    1. Epilepsy–symptoms and causes. Mayo Clinic. 2021. Accessed June 27, 2022. mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093.
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