Journal article
PACES in epilepsy: Results of a self-management randomized controlled trial
Epilepsia (Copenhagen), Vol.56(8), pp.1264-1274
08/2015
Handle:
https://hdl.handle.net/2376/104285
PMID: 26122460
Abstract
Self-management challenges facing adults with epilepsy include limited understanding of the condition and treatment, associated psychosocial issues, and lack of community integration. Self-management interventions improve patients' medical, life role, and emotional management. Previous interventions, developed from expert opinion, indicated issues with participant engagement/retention, and limited follow-up periods. PACES in Epilepsy addressed methodologic concerns by utilizing patient needs assessment data (n = 165) to derive self-management content and program features for evaluation via randomized controlled trial (RCT).
Participants were adults with chronic epilepsy (n = 83), without serious mental illness or substantive intellectual impairment, who were recruited from two epilepsy centers. Participants were assigned randomly to intervention or treatment-as-usual groups. Outcomes included the Epilepsy Self-Management Scale (ESMS), Epilepsy Self-Efficacy Scale (ESES), Quality of Life in Epilepsy-31 (QOLIE-31), Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7), administered at baseline, postintervention (8 weeks), and 6 months postintervention. The intervention was an 8-week group of 6-8 adults co-led by a psychologist and trained peer with epilepsy that met one evening per week at a hospital for 75 min. Topics included medical, psychosocial, cognitive, and self-management aspects of epilepsy, in addition to community integration and optimizing epilepsy-related communication. The treatment group provided satisfaction ratings regarding program features.
PACES participants (n = 38) improved relative to controls (n = 40) on the ESMS (p < 0.001) and subscales [Information (p < 0.001); Lifestyle (p < 0.002)]; ESES (p < 0.001); and QOLIE-31 (p = 0.002). At 6-month follow up, PACES participants remained improved on the ESMS (p = 0.004) and Information subscale (p = 0.009); and Energy/Fatigue (p = 0.032) and Medication Effects (p = 0.005) of the QOLIE-31. Attrition in both groups was low (8% in each group) and all program satisfaction ratings exceeded 4.0/5.0, with leadership (4.76), topics (4.53), and location (4.30) as the most highly rated aspects.
A consumer generated epilepsy self-management program appears to be a promising intervention from multiple perspectives, particularly in relation to disability management.
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Details
- Title
- PACES in epilepsy: Results of a self-management randomized controlled trial
- Creators
- Robert T Fraser - Neurology Vocational Services Unit, University of Washington, Seattle, Washington, U.S.AErica K Johnson - Health Promotion Research Center, University of Washington, Seattle, Washington, U.S.ASteven Lashley - Neurology Vocational Services Unit, University of Washington, Seattle, Washington, U.S.AJason Barber - Neurological Surgery, University of Washington, Seattle, Washington, U.S.ANaomi Chaytor - Rehabilitation Medicine, University of Washington, Seattle, Washington, U.S.AJohn W Miller - Neurology, University of Washington, Seattle, Washington, U.S.APaul Ciechanowski - Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, U.S.ANancy Temkin - Biostatistics, University of Washington, Seattle, Washington, U.S.ALisa Caylor - Swedish Neuroscience Institute, Seattle, Washington, U.S.A
- Publication Details
- Epilepsia (Copenhagen), Vol.56(8), pp.1264-1274
- Academic Unit
- Medical Education and Clinical Science, Department of
- Publisher
- United States
- Grant note
- DP002273 / NCCDPHP CDC HHS
- Identifiers
- 99900546962801842
- Language
- English
- Resource Type
- Journal article