Barriers and facilitators to starting and staying on ketogenic diet therapy for children with epilepsy: A scoping review

IF 2.9 Q3 NUTRITION & DIETETICS
Humzah Hameed , Lenycia de Cassya Lopes Neri , Natasha Schoeler
{"title":"Barriers and facilitators to starting and staying on ketogenic diet therapy for children with epilepsy: A scoping review","authors":"Humzah Hameed ,&nbsp;Lenycia de Cassya Lopes Neri ,&nbsp;Natasha Schoeler","doi":"10.1016/j.clnesp.2025.02.020","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Ketogenic diet therapy (KDT) is a group of high-fat, low-carbohydrate, moderate protein diets that are an effective treatment option for children and young people with drug-resistant epilepsy. However, 45 % of patients referred to start KDT, who are medically eligible to do so, do not start diet. A further 25 % discontinue KDT before 3 months.</div></div><div><h3>Aim</h3><div>To explore barriers and facilitators for children and young people with epilepsy to start or continue on KDT, and their families. Based on the Participants, Concept and Context (PCC) framework, this review included children and young people with drug-resistant epilepsy (P) referred for KDT (C) or their families, who had expressed their views regarding barriers or facilitators for starting or continuing on dietary treatment (C).</div></div><div><h3>Methods</h3><div>This scoping review followed JBI methodology. Identified barriers/facilitators were matched to relevant sections of the ‘Capability, Opportunity, Motivation – Behaviour’ (COM-B) model and organised according to the phases of the patient journey: pre-diet, diet initiation and maintenance.</div></div><div><h3>Results</h3><div>60 studies were included. 15 barriers and 9 facilitators were identified for the pre-diet and initiation stages; 19 barriers and 14 facilitators were identified for staying on KDT once the diet had been fully established.</div></div><div><h3>Conclusions</h3><div>Barriers and facilitators for children and young people who are considering starting KDT, or who are currently following KDT, and their families, are multifactorial and extend beyond the level of the individual. Our findings will help identify areas to prioritise for interventions to support patients and their families.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 465-473"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S240545772500083X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Ketogenic diet therapy (KDT) is a group of high-fat, low-carbohydrate, moderate protein diets that are an effective treatment option for children and young people with drug-resistant epilepsy. However, 45 % of patients referred to start KDT, who are medically eligible to do so, do not start diet. A further 25 % discontinue KDT before 3 months.

Aim

To explore barriers and facilitators for children and young people with epilepsy to start or continue on KDT, and their families. Based on the Participants, Concept and Context (PCC) framework, this review included children and young people with drug-resistant epilepsy (P) referred for KDT (C) or their families, who had expressed their views regarding barriers or facilitators for starting or continuing on dietary treatment (C).

Methods

This scoping review followed JBI methodology. Identified barriers/facilitators were matched to relevant sections of the ‘Capability, Opportunity, Motivation – Behaviour’ (COM-B) model and organised according to the phases of the patient journey: pre-diet, diet initiation and maintenance.

Results

60 studies were included. 15 barriers and 9 facilitators were identified for the pre-diet and initiation stages; 19 barriers and 14 facilitators were identified for staying on KDT once the diet had been fully established.

Conclusions

Barriers and facilitators for children and young people who are considering starting KDT, or who are currently following KDT, and their families, are multifactorial and extend beyond the level of the individual. Our findings will help identify areas to prioritise for interventions to support patients and their families.
癫痫儿童开始和坚持生酮饮食疗法的障碍和促进因素:范围综述。
背景:生酮饮食疗法(KDT)是一组高脂肪、低碳水化合物、中等蛋白质的饮食,是儿童和青少年耐药癫痫的有效治疗选择。然而,在医学上有资格开始KDT的患者中,有45%没有开始节食。另有25%的患者在3个月前停用KDT。目的:探讨癫痫儿童和青少年及其家庭开始或继续接受KDT治疗的障碍和促进因素。基于参与者、概念和背景(PCC)框架,本综述纳入了接受KDT (C)的儿童和青少年耐药癫痫(P)患者或其家庭,他们对开始或继续饮食治疗的障碍或促进因素表达了自己的观点(C)。方法:本综述采用JBI方法。确定的障碍/促进因素与“能力,机会,动机-行为”(COM-B)模型的相关部分相匹配,并根据患者旅程的各个阶段进行组织:饮食前,饮食开始和维持。结果:纳入60项研究。在饮食前和开始阶段确定了15个障碍和9个促进因素;确定了19个障碍和14个促进因素,以便在饮食完全建立后继续使用KDT。结论:对于正在考虑开始KDT或正在进行KDT的儿童和青少年及其家庭来说,障碍和促进因素是多方面的,并且超出了个人的层面。我们的研究结果将有助于确定优先干预的领域,以支持患者及其家属。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信