Abstract
Introduction Autoimmune encephalitis (AE) is an acute neuroinflammatory disease that can be difficult to diagnose and treat. Access to medical services is often poor for patients in rural and regional settings and may impact the outcomes for a rare disease such as AE.
Objective To explore treatment access for patients with AE in a rural or regional setting
Methods Patients with AE at four tertiary metropolitan sites and one regional site in Victoria were evaluated qualitatively for basic demographics, first and second-line treatment parameters and functional outcomes (mRS) at 12 months. Metropolitan patients were divided into those from rural/regional settings compared with those from metropolitan settings.
Results We identified 159 patients with AE. 144 patients were treated at a metropolitan hospital of which 19 patients were from a rural setting. 15 patients were from a rural setting. Firstline therapy was provided for the majority of patients, however regional patients had a small treatment delay compared with patients at a metropolitan hospital (59 vs 49 days) and no regional patients received second line therapy (0% vs 48%). Outcomes at 12 months were similar between the three groups.
Conclusion Patients with AE treated in regional hospitals had reduced second-line therapy compared with metropolitan patients. However, this did not impact longer term outcome which may demonstrate the presence of appropriate referral pathways from regional to tertiary hospitals.
