Study protocol for a case series: implementation and evaluation of an integrated mental and physical healthcare programme to screen for mental health symptoms in people with epilepsy

• Published in: BMJ open 2023-10, Vol.13 (10), p.e075043-e075043
• Main Authors: Winsor, Alice Afua, Ebelthite, Candice, Onih, Jemima, Nicholson, Timothy R, Pal, Deb K, Richardson, Mark
• Format: Article
• Language: English
• Subjects: Adolescent; Adults; Clinical outcomes; Clinics; Convulsions & seizures; Delivery of Health Care; Epilepsy; Epilepsy - diagnosis; Health Informatics; Hospitals; Humans; Intellectual disabilities; Medical personnel; Medical screening; Mental Disorders - complications; Mental Disorders - diagnosis; Mental Disorders - therapy; Mental Health; patient reported outcome measures; Patients; Pediatrics; Self help; Smartphones; State Medicine
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-075043

IntroductionThe prevalence of mental health symptoms in people with epilepsy (PWE) is elevated compared with that of the general population. These symptoms can negatively impact epilepsy management and patient outcomes but can be treated once recognised. It is, therefore, important to screen for these symptoms to identify needs and put in place appropriate support. Unfortunately, mental health symptoms are rarely addressed in epilepsy services due to time constraints, lack of resources and communication between psychological and medical professionals. These barriers can result in diagnostic overshadowing, where symptoms may be attributed to the disease and reduce the level of support PWE receive. Implementing an online screening tool embedded in the electronic health record (EHR) platform with supported referral pathways may remove some of these barriers.Methods and analysisWe will follow the Integrating Mental and Physical Healthcare: Research Training and Services framework, which is a routine clinical data collection tool used by clinical teams to electronically screen psychological symptoms among patients with long-term physical health conditions. Patient outcomes including mental health, physical health and psychosocial outcomes will be collected and uploaded to the EHR platform in real-time. An appropriate referral pathway will be recommended depending on severity of the outcome scores. We will initially pilot the tool for individuals aged 13 years and above through epilepsy clinics at King’s College Hospital. Following this, the acceptability and feasibility of the tool will be assessed at baseline, 6 and 12 months.Ethics and disseminationEthics approval was obtained from the National Health Service Research Ethics Committee of South Central—Oxford C, reference: 21/EM/0205. This study is expected to inform the use of integrated electronic mental health screening for youth in epilepsy clinics and improve access to psychological support. The findings will be disseminated through academic peer-reviewed journals, poster presentations and scientific meetings.