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Evaluation des barrières d'accessibilité aux antiépileptiques dans les pays en développement

Abstract : Epilepsy is one of the most common neurological diseases found in the world. Epidemiological indicators are higher in developing countries and the treatment gap is important. There are no study on the overall assessment of the barriers to accessibility of antiepileptic drugs (AEDs) in those countries. In order to develop an assessment tool of these barriers, we conducted four studies: a systematic review of the literature on potential barriers to access to treatment and health care regardless of the medical discipline; a field survey in Madagascar to establish specific barriers to AEDs and determine their quality; a study in Benin in order to determine the specific barriers in this country and a study in Ecuador based on the same evaluation tool used in Benin. To strengthen our method of evaluation we conducted a door-to-door survey in Ecuador and a Delphi consensus method on our main results. Our work has highlighted the main barriers to access of AEDs in Benin, which are lack of information for patients and healthcare professionals about the disease, and the lack of neurologists and physicians trained in the care of epilepsy. These barriers were also found in Ecuador, with, in addition, restrictions on prescription of doctors in the public hospitals. Our tool has demonstrated its interest in the evaluation of antiepileptic access barriers in developing countries.
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Mandy Nizard. Evaluation des barrières d'accessibilité aux antiépileptiques dans les pays en développement. Sociologie. Université de Limoges, 2016. Français. ⟨NNT : 2016LIMO0100⟩. ⟨tel-01436426⟩

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