Effect of intensive self-management education on seizure frequency and quality of life in epilepsy patients with prodromes or precipitating factors
Effect of intensive self-management education on seizure frequency and quality of life in epilepsy patients with prodromes or precipitating factors
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DOI：
10.1016/j.seizure.2020.03.003
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发表时间：
2020-05-01
影响因子：
3
通讯作者：
Sun, Hongbin
中科院分区：
文献类型：
--
作者：
Hu, Meiling;Zhang, Chenqi;Sun, Hongbin
目的：探讨强化自我管理教育策略对有促发或诱发因素的癫痫发作患者发作频率和生活质量的影响。强化自我管理教育包括每月一次的预防和诱发因素教育，旨在帮助患者采取自我管理strategies.Methods：成年癫痫患者（PWE）能够识别他们的癫痫发作的预防或诱发因素随机分为强化教育组（IEG）（n = 45）和常规教育组（REG）（n = 47）。所有患者在入组时均接受一次面对面的自我管理教育。两组患者每月接受电话随访，持续1年。在每次后续电话会议期间，国际环境小组的PWE都接受了强化教育。主要结果为癫痫发作频率、生活质量（癫痫生活质量-31量表评分，QOLIE 31）和药物依从性（Morisky药物依从性量表，MMAS）。结果：在1年随访期结束时，IEG的癫痫发作频率显著低于基线（p < 0.001），但REG中没有（p = 0.085）。生活质量在IEG中有显著改善（p < 0.001），但在REG中没有改善（p = 0.073）。IEG组的药物依从性好于REG组（p = 0.003），意外伤害发生率低于REG组（p = 0.031）。结论：在意识到癫痫发作诱因或诱发因素的PWE中，加强自我管理教育可以减少癫痫发作频率，提高生活质量，增加抗癫痫药物的依从性，减少癫痫发作引起的意外伤害。
Purpose: To explore the impact of an intensive self-management education strategy on seizure frequency and quality of life in patients with epileptic seizures with prodromes or precipitating factors. The intensive self-management education included monthly education sessions on prodromes and precipitating factors aiming to help patients to adopt self-management strategies.Methods: Adult patients with epilepsy (PWE) able to identify prodromes or precipitating factors of their seizures were randomly assigned to an intensive education group (IEG) (n = 45) or a regular education group(REG) (n = 47). All patients received a single face-to-face self-management education session at the time of enrollment. Both groups of patients received monthly telephone follow-up for 1 year. PWE in the IEG received intensive education during each follow-up call. Primary outcomes were seizure frequency, quality of life(Quality of life in epilepsy-31 inventory scores, QOLIE 31), and drug adherence(Morisky medication adherence scale,MMAS).Results: At the end of the 1-year follow-up period, seizure frequency in the IEG was significantly lower than at baseline (p < 0.001), but not in the REG(p = 0.085). Quality of life had improved significantly in the IEG (p < 0.001), but not in the REG (p = 0.073). Drug adherence was better in the IEG than in the REG (p = 0.003), and there were fewer accidental injuries in the IEG than the REG (p = 0.031).Conclusions: In PWE aware of seizure prodromes or precipitating factors, intensive self-management education may reduce seizure frequency, improve quality of life, increase adherence with antiepileptic medication and reduce accidental injuries caused by seizures.