The role of implementation science in improving epilepsy surgery utilization.

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Abstrakt

Tytuł:: The role of implementation science in improving epilepsy surgery utilization.
Autorzy:: Samanta D; Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States. Electronic address: .
Źródło:: Epilepsy & behavior : E&B [Epilepsy Behav] 2022 May; Vol. 130, pp. 108669. Date of Electronic Publication: 2022 Mar 22.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Original Publication: San Diego, CA : Academic Press, c2000-
MeSH Terms:: Epilepsy*/surgery
Implementation Science*
Humans ; Neurologists ; Quality Improvement
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Grant Information:: UL1 TR003107 United States TR NCATS NIH HHS
Contributed Indexing:: Keywords: Complexity science; Epilepsy care coordinator; Magnetoencephalography; Process improvement; Quality initiatives
Entry Date(s):: Date Created: 20220325 Date Completed: 20220504 Latest Revision: 20230502
Update Code:: 20240105
PubMed Central ID:: PMC9064925
DOI:: 10.1016/j.yebeh.2022.108669
PMID:: 35334257
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Randomized controlled studies demonstrated that patients with intractable epilepsy could benefit significantly more from epilepsy surgery than from continuing medical therapy. Unfortunately, robust efforts over the last few decades, including the formation and dissemination of guidelines and practice parameters, did not improve the utilization of epilepsy surgery. Epilepsy surgery remains one of the most underutilized evidence-based interventions in modern medicine. A new scientific study of methods has emerged to improve uptake of evidence-based practices, named implementation science (IS). Despite its tremendous rise in popularity in various domains, its usage to mitigate epilepsy surgery underutilization is very limited. In fact, the application of principles and methods of IS are somewhat restricted in the entire neuroscience field, where quality improvement (QI) efforts primarily drive the provision of high-quality health care. Although both QI efforts and IS have a similar goal of improving healthcare quality, they differ significantly in associated terminologies, concepts, and approaches. For implementing high-quality, evidence-based practices in routine clinical settings, we need a better understanding of IS methods and closer integration between QI and IS fields. Recognizing a dearth of awareness of IS in the neuroscience community, the first part of the review addresses the fundamentals of IS, focusing on multifaceted implementation strategies that neurologists can apply in their clinical practice. In the second part of the review, an entire illustrative case is presented to familiarize neurologists with the practical application of diverse implementation strategies to mitigate the underutilization of epilepsy surgery.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier Inc. All rights reserved.)

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