Unraveling unmet needs in ketogenic dietary services: An ERN EpiCARE survey

Author:

De Giorgis Valentina12ORCID,Pasca Ludovica12ORCID,Aznar‐Lain Gemma3,Bibic Irena4,Bibic Vedrana4,Darra Francesca5ORCID,Dianin Alice6,Dressler Anastasia7ORCID,Jonsson Henna8ORCID,Komulainen‐Ebrahim Jonna910,Kverneland Magnhild11ORCID,Molteberg Ellen1112ORCID,Ragona Francesca13,de Saint‐Martin Anne14ORCID,Varesio Costanza12ORCID,Cross J. Helen1516ORCID,

Affiliation:

1. Department of Brain and Behaviour Neuroscience University of Pavia Pavia Italy

2. Child Neurology and Psychiatry Unit IRCCS Mondino Foundation, Full Member of European Reference Network EpiCARE Pavia Italy

3. Paediatric Neurology Hospital del Mar, Hospital del Mar Reasearch Institute (IMIM), University Pompeu Fabra, Full Member of European Reference Network EpiCARE Barcelona Spain

4. Dravet Sindrom Hrvatska ePAG of European Reference Network EpiCARE Split Croatia

5. Child Neuropsychiatry Unit, Department of Engineering for Innovation Medicine University of Verona, Full Member of European Reference Network EpiCARE Verona Italy

6. Inherited Metabolic Diseases Unit and Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases Azienda Ospedaliera Universitaria Integrata Verona Italy

7. Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Department of Paediatrics and Adolescent Medicine Medical University of Vienna, Full Member of European Reference Network EpiCARE Vienna Austria

8. Department of Pediatric Neurology, New Children's Hospital and Pediatric Research Center, Epilepsia Helsinki Helsinki University Hospital and University of Helsinki, Full Member of European Reference Network EpiCARE Helsinki Finland

9. Research Unit of Clinical Medicine andMedical Research Center Oulu University Hospital, University of Oulu Oulu Finland

10. Department of Children and Adolescents, Division of Pediatric Neurology Oulu University Hospital, Full Member of European Reference Network EpiCARE Oulu Finland

11. National Centre for Epilepsy Oslo University Hospital, Full Member of European Reference Network EpiCARE Oslo Norway

12. Institute of Clinical Medicine, University of Oslo Oslo Norway

13. Department of Pediatric Neurology IRCCS Foundation Carlo Besta Neurological Institute, Full Member of European Reference Network EpiCARE Milan Italy

14. Department of Pediatric Neurology Strasbourg University Hospital, Full Member of European Reference Network EpiCARE Strasbourg France

15. Developmental Neurosciences Research and Teaching Department University College London NIHR BRC Great Ormond Street Institute of Child Health London UK

16. Paediatric Neurosciences Great Ormond Street Hospital for Children London UK

Abstract

AbstractThe implementation and potential of ketogenic dietary therapies (KDTs) have changed over time. The organization of KDT services, the availability of multidisciplinary teams, resources and support for patients and families still vary widely around the world. This diversity is reflected by a lack of consistency in reported outcomes, optimization of using KDT and KDT compliance. To highlight the unmet needs for KDT services, the ERN EpiCARE Ketogenic Dietary Therapy Special Interest Group (KDT SIG) conducted an online survey on KDT implementation and utilization, addressing the following topics: Use and completeness of guidelines and protocols; assessment of compliance and outcome parameters, sustainability and inclusivity in daily life. Consistently reported unmet needs included the lack of psychological support and resources to measure and improve adherence to KDT, the lack of inclusion strategies, and shared guidelines and protocols adapting to specific needs. Future interventions should focus primarily on educational and informative measures together with creation of shared protocols for complex care.Plain Language SummaryThis study provides the results of a survey compiled by clinicians and patients representatives belonging to ERN Epicare, designed to unravel unmet needs from both patients' and healthcare practitioners' perspectives during ketogenic dietary therapies (KDT) provision. Importantly, results show the need to create new shared protocols and guidelines meant for KDT use in complex care situations and to develop future strategies initiatives to support patients improving their social inclusivity.

Publisher

Wiley

Reference14 articles.

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