Epilepsy awareness among physicians in plains and plateau regions of western China: a cross-sectional study.

Abstract

Background: Epilepsy is a common neurological disorder affecting about 50 million people worldwide. Disparities in healthcare resources lead to geographical variation in its diagnosis, treatment, and management. In particular, the gap between plains and plateau regions in western China remains understudied. Assessing healthcare professionals' expertise and delivering targeted training represent effective strategies to narrow this treatment gap. We compare epilepsy knowledge between physicians in more developed plains regions and less developed plateau regions of western China in order to inform targeted interventions to address regional disparities.

Methods: In this cross-sectional study, physicians attending epilepsy training sessions in three cities representative of the western plains region of China (Chengdu) and of the western plateau region (Lhasa and Xichang) completed a questionnaire assessing knowledge in several modules of the disease, including its diagnosis, preoperative evaluation, drug and surgical treatments, and management during pregnancy.

Results: Of the 349 participants given questionnaires, 325 (93.1%) were included in the final analysis. Physicians from the plateau region scored significantly lower than physicians from the plains region on knowledge about epilepsy diagnosis (Number of questions with discrepancies / Total number of questions in this module, i.e., 7/7, P < 0.05), definition of drug-resistant epilepsy (2/2 questions P < 0.05), preoperative evaluation and surgical treatments (7/14 questions P < 0.05), status epilepticus (2/2 questions P < 0.05), epilepsy comorbidities (2/2 questions P < 0.05), and epilepsy management during pregnancy (3/3 questions P < 0.05). However, no significant differences were found between neurology specialists in plateau regions and those in plain regions across all six epilepsy knowledge modules and the overall score (0.542 < P < 0.829).

Conclusions: Significant gaps persist in epilepsy care knowledge among physicians in western plateau of China, particularly in diagnosis, treatment, and specialized management. Both plateau and plains regions lack awareness of advanced preoperative evaluation techniques. Targeted training and capacity-building interventions are needed, with effectiveness evaluated through longitudinal studies.