Improving Quality of Life in Epilepsy

Self-management training can improve the quality of life of patients with epilepsy, according to a small case-control study published in September. 

Epilepsy treatment has traditionally focused on medical therapy, sometimes to the exclusion of psychosocial and quality of life issues. Yet epilepsy can affect many factors that influence patients’ quality of life. Coping with chronic illness, medication issues and side effects, as well as cognitive and behavioral issues related to epilepsy can all have detrimental effects on quality of life. Stigma, especially in Asian countries, can impact epilepsy patients’ self-esteem and social functioning. Epilepsy can also negatively affect family stability, as well as financial, educational, and employment opportunities, according to background information in the article.

The case-control study included 60 patients being treated for epilepsy at the Zanjan Neurology Clinic, which is affiliated with a teaching hospital in Zanjan, Iran. Almost 62% of patients were 18-25 years old, 51.7% were male, and 95% had generalized seizures. Researchers randomized 30 patients to receive pamphlets and four training sessions about the medical aspects of epilepsy and self-management, including lifestyle and stress management. Controls (n=30) received routine clinical care. Patients completed self-reported, standardized quality of life questionnaires before and one month after the intervention. 

Results showed:

• Before the intervention:

♦ Total quality of life: No statistical difference between the intervention and control groups (p=0.444).

• After the intervention:

♦ Total quality of life: Statistically different between the intervention and control groups (p<0.001).

♦ The intervention group had statistically better overall quality of life (p=0.004), social functioning (p=0.039), medication effects (p<0.001), cognitive functioning (p=0.014), energy/fatigue (p<0.001), mental health (p<0.001), and worry about seizures (p<0.001), compared to the control group.

• Patients had statistically significant differences in total quality of life before and after the study in the intervention group (p<0.001), but not in controls (p=0.620).

 “After the intervention, quality of life and its dimensions in the case group improved significantly, and the difference between case and control groups was statistically significant…” concluded first author Mohammed Ali Yadegary, MD, of Tehran University, and colleagues the Zajan University of Medical Sciences. “[T]raining patients and their families about epilepsy plays an important role in coping with the disease and increases patients’ self-confidence and self-management skills that make[s] patients aware of their needs and [how] to access specific resources [for] these needs.”

Epilepsy self-management programs should be started immediately after an epilepsy diagnosis, the authors recommended, because studies have suggested that starting these programs early can maximize their effect.

Take Home Points

• Epilepsy can affect multiple variables that impact patients’ quality of life.

• A small case control study in Iran has found that patients who participated in an epilepsy self-management program had improved quality of life.

• Patients should start epilepsy self-management programs as soon as possible after receiving a diagnosis of epilepsy.

Reference: Yadegary MA, et al. The effect of self-management training on health-related quality of life in patients with epilepsy. Epilepsy Behav. 2015 Sep;50:108-112.