Abstract
Objective Ketogenic Diet Therapy (KDT) is an established treatment for epilepsy. Evidence demonstrates efficacy on seizure frequency, cognition and behaviour. Evaluation of factors affecting KDT prescribing is essential to strengthen quality, evidenced-based equitable care.
Methods A cross-sectional cohort study of Australian and New Zealand Neurologists was performed via an online multiple choice survey in late 2022. Demographics, clinical characteristics, perceptions and experiences of epilepsy KDT were assessed. Responses were analyzed using the Capability, Opportunity, Motivation and Behaviour model. Frequencies and percentages were reported for categorical variables. Chi-squared analysis and Fisher exact tests were used to assess relationships between clinical role, knowledge, and KDT use. A p-value of <0.05 was regarded as significant.
Results 114 neurologists participated in the survey (18% response rate). All were aware of KDT for epilepsy, 90% perceived it as acceptable and 85% identified KDT suitable patients in their practice. 24% reported ‘strong’ knowledge and used KDT in their practice. Clinical characteristics associated with KDT use in practice were being a paediatric neurologist (p<0.00001), an epileptologist (p<0.00001) and urban practice. ‘No’ or ‘basic’ knowledge of referral pathways was a barrier for 64%. 90% endorsed adoption of a national KDT guideline to facilitate KDT use in epilepsy treatment.
Conclusions KDT is an accepted treatment for people with epilepsy in our region but there is high variability in knowledge and skill affecting its utilization. These results highlight the gaps in knowledge and access and can be used to guide effective planning and implementation of KDT for epilepsy programmes.
