Medication adherence in patients with epilepsy after a single neurologist visit in rural India

• Mobile clinics can be an effective way to initiate chronic seizure treatment for patients in remote and socioeconomically-challenged areas.
• Overall, 72.5% patients reported adherence to antiepileptic medication 7–9 months after a single neurologist visit.
• We advocate that patient education and counseling and training of caregivers be an integral component of such mobile clinics.

In India, there are less than 2000 neurologists, and an estimated 5 million patients have epilepsy. With such limited neurological care available, novel treatment approaches for epilepsy are necessary. This study evaluates the effectiveness of a mobile clinic in treating epilepsy. Patients from two mobile clinic stop locations in northern India were contacted 7 and 9 months later for an in-person or over-the-phone survey. Of the 306 eligible patients who had been seen in the selected cities, 142 were interviewed, 72.5% of whom reported that they were still taking medications; among medication-naïve patients, 50.9% were still taking medications. The one-time clinic is effective and could be a model for working towards reducing the wide rural epilepsy treatment gap in India and other countries. Creative follow-up mechanisms need to be developed.