Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops

Background Nearly 25% of people with intellectual disability (PwID) have epilepsy compared to 1% of the UK general population. PwID are commonly excluded from research, eventually affecting their care. Understanding seizures in PwID is particularly challenging because of reliance on subjective exter...

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Main Authors: Edward Meinert, Madison Milne-Ives, Jennifer Sawyer, Liz Boardman, Sarah Mitchell, Brendan Mclean, Mark Richardson, Rohit Shankar
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472424008251/type/journal_article
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author Edward Meinert
Madison Milne-Ives
Jennifer Sawyer
Liz Boardman
Sarah Mitchell
Brendan Mclean
Mark Richardson
Rohit Shankar
author_facet Edward Meinert
Madison Milne-Ives
Jennifer Sawyer
Liz Boardman
Sarah Mitchell
Brendan Mclean
Mark Richardson
Rohit Shankar
author_sort Edward Meinert
collection DOAJ
description Background Nearly 25% of people with intellectual disability (PwID) have epilepsy compared to 1% of the UK general population. PwID are commonly excluded from research, eventually affecting their care. Understanding seizures in PwID is particularly challenging because of reliance on subjective external observation and poor objective validation. Remote electroencephalography (EEG) monitoring could capture objective data, but particular challenges and implementation strategies for this population need to be understood. Aim This co-production aimed to explore the accessibility and potential impact of a remote, long-term EEG tool (UnEEG 24/7 SubQ) for PwID and epilepsy. Method We conducted six, 2-hour long workshops; three with people with mild intellectual disability and three with families/carers of people with moderate–profound intellectual disability. Brief presentations, easy read information and model demonstrations were used to explain the problem and device. A semi-structured guide developed by a communication specialist and art-based techniques facilitated discussion with PwID. For family/carers, active listening was employed. All conversations were recorded and transcribed. Artificial intelligence-based coding and thematic analysis (ATLAS.ti and ChatGPT) were synthesised with manual theming to generate insights. Results Co-production included four PwID, five family members and seven care professionals. Three main themes were identified: (1) perceived benefits for improving seizure understanding, informing care and reducing family and carer responsibility to accurately identify seizures; (2) the device was feasible for some PwID but not all; and (3) appropriate person-centred communication is essential for all stakeholders to reduce concerns. Conclusions The workshops identified key benefits and implementing barriers to SubQ in PwID.
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spelling doaj-art-941d30eff8a44fb5965da2dd4aad85aa2025-08-20T02:49:49ZengCambridge University PressBJPsych Open2056-47242025-01-011110.1192/bjo.2024.825Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshopsEdward Meinert0Madison Milne-Ives1https://orcid.org/0000-0001-7628-882XJennifer Sawyer2Liz Boardman3Sarah Mitchell4Brendan Mclean5Mark Richardson6Rohit Shankar7https://orcid.org/0000-0002-1183-6933Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; and Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UKTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; and Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth, UKPlymouth Dental School, Faculty of Health, University of Plymouth, Plymouth, UKCornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Bodmin, UKCornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Bodmin, UK; and Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UKPeninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK; and Department of Neurology, Royal Cornwall Hospitals NHS Trust, Treliske, UKDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UKCornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Bodmin, UK; and Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UKBackground Nearly 25% of people with intellectual disability (PwID) have epilepsy compared to 1% of the UK general population. PwID are commonly excluded from research, eventually affecting their care. Understanding seizures in PwID is particularly challenging because of reliance on subjective external observation and poor objective validation. Remote electroencephalography (EEG) monitoring could capture objective data, but particular challenges and implementation strategies for this population need to be understood. Aim This co-production aimed to explore the accessibility and potential impact of a remote, long-term EEG tool (UnEEG 24/7 SubQ) for PwID and epilepsy. Method We conducted six, 2-hour long workshops; three with people with mild intellectual disability and three with families/carers of people with moderate–profound intellectual disability. Brief presentations, easy read information and model demonstrations were used to explain the problem and device. A semi-structured guide developed by a communication specialist and art-based techniques facilitated discussion with PwID. For family/carers, active listening was employed. All conversations were recorded and transcribed. Artificial intelligence-based coding and thematic analysis (ATLAS.ti and ChatGPT) were synthesised with manual theming to generate insights. Results Co-production included four PwID, five family members and seven care professionals. Three main themes were identified: (1) perceived benefits for improving seizure understanding, informing care and reducing family and carer responsibility to accurately identify seizures; (2) the device was feasible for some PwID but not all; and (3) appropriate person-centred communication is essential for all stakeholders to reduce concerns. Conclusions The workshops identified key benefits and implementing barriers to SubQ in PwID. https://www.cambridge.org/core/product/identifier/S2056472424008251/type/journal_articleIntellectual disabilityepilepsyelectroencephalographyco-productionpatient and public involvement
spellingShingle Edward Meinert
Madison Milne-Ives
Jennifer Sawyer
Liz Boardman
Sarah Mitchell
Brendan Mclean
Mark Richardson
Rohit Shankar
Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
BJPsych Open
Intellectual disability
epilepsy
electroencephalography
co-production
patient and public involvement
title Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
title_full Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
title_fullStr Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
title_full_unstemmed Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
title_short Subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability: co-production workshops
title_sort subcutaneous electroencephalography monitoring for people with epilepsy and intellectual disability co production workshops
topic Intellectual disability
epilepsy
electroencephalography
co-production
patient and public involvement
url https://www.cambridge.org/core/product/identifier/S2056472424008251/type/journal_article
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