Analysis of the implementation process for anti-epileptic treatment in Ecuador

International audienceBackground: The World Health Organization estimates that 50 million people worldwide have epilepsy and nearly 80% of them are found in developing countries. Although epilepsy responds to treatment in 70-80% of individuals, a major problem is the lack of access to appropriate treatment. Furthermore, we know that the treatment of epilepsy is limited by several factors: the difficulty of tracking the different stages of treatment, lack of qualified staff, the tools for securing the diagnosis, non-compliance with the therapeutic dosing because of beliefs, and the high cost of antiepileptic drugs (AEDs).Objective: The main objective of this study was to determine the most important actions necessary to improve the accessibility of anti-epileptic drugs (AEDs) in rural and urban areas in Ecuador.Patients and methods: An observational epidemiological study is underway in Quito and the province of Napo in Ecuador from January 2015, to September 2016. Different surveys will assess all the AED circuits including the Ministry of Health and national services, components of the medical circuit (wholesalers, drug manufacturers and retailers) prescribers and healthcare facilities and the people with epilepsy. We are going to use three sources of information (medical records, key informants and door-to-door surveys) to find patients with epilepsy in these study areas.Expected results: The goal is to identify the barriers and facilitators to access of care and especially of AEDs, one of the first steps needed to improve health access for patients with epilepsy in Ecuador