Self-management of Epilepsy: A Systematic Review.

Luedke, Matthew W

Blalock, Dan V

Goldstein, Karen M

Kosinski, Andrzej S

Sinha, Saurabh R

Drake, Connor

Lewis, Jeffrey D

Husain, Aatif M

Lewinski, Allison A

Shapiro, Abigail

Gierisch, Jennifer M

Tran, Tung T

Gordon, Adelaide M

Van Noord, Megan G

Bosworth, Hayden B

Williams, John W

2024-01-25T17:30:38Z

2024-01-25T17:30:38Z

2019-07

Background:Although self-management is recommended for persons with epilepsy, its optimal strategies and effects are uncertain. Purpose:To evaluate the components and efficacy of self-management interventions in the treatment of epilepsy in community-dwelling persons. Data Sources:English-language searches of MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL in April 2018; the MEDLINE search was updated in March 2019. Study Selection:Randomized and nonrandomized comparative studies of self-management interventions for adults with epilepsy. Data Extraction:An investigator assessed study characteristics; intervention details, including 6 components of self-management; and outcomes, which were verified by a second reviewer. Risk of bias (ROB) was assessed independently by 2 investigators. Data Synthesis:13 randomized and 2 nonrandomized studies (2514 patients) evaluated self-management interventions. Interventions were delivered primarily in group settings, used a median of 4 components, and followed 2 general strategies: 1 based on education and the other on psychosocial therapy. Education-based approaches improved self-management behaviors (standardized mean difference, 0.52 [95% CI, 0.0 to 1.04]), and psychosocial therapy-based approaches improved quality of life (mean difference, 6.64 [CI, 2.51 to 10.77]). Overall, self-management interventions did not reduce seizure rates, but 1 educational intervention decreased a composite of seizures, emergency department visits, and hospitalizations. Limitation:High ROB in most studies, incomplete intervention descriptions, and studies limited to English-language publications. Conclusion:There is limited evidence that self-management strategies modestly improve some patient outcomes that are important to persons with epilepsy. Overall, self-management research in epilepsy is limited by the range of interventions tested, the small number of studies using self-monitoring technology, and uncertainty about components and strategies associated with benefit. Primary Funding Source:U.S. Department of Veterans Affairs. (PROSPERO: CRD42018098604).

2737361

0003-4819

1539-3704

https://hdl.handle.net/10161/29858

eng

American College of Physicians

Annals of internal medicine

10.7326/m19-0458

https://creativecommons.org/licenses/by-nc/4.0

Humans

Epilepsy

Self-Management

Self-management of Epilepsy: A Systematic Review.

Journal article

Luedke, Matthew W|0000-0002-1564-0241

Blalock, Dan V|0000-0002-8349-9825

Goldstein, Karen M|0000-0003-4419-5869

Kosinski, Andrzej S|0000-0003-4151-5185

Sinha, Saurabh R|0000-0003-0305-6731

Drake, Connor|0000-0002-5393-6246

Husain, Aatif M|0000-0001-7954-1755

Lewinski, Allison A|0000-0002-1356-1857

Bosworth, Hayden B|0000-0001-6188-9825

Williams, John W|0000-0002-5267-5558

117

126

2

Duke

School of Medicine

School of Nursing

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Basic Science Departments

Clinical Science Departments

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Biostatistics & Bioinformatics

Medicine

Psychiatry & Behavioral Sciences

Medicine, General Internal Medicine

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Duke Clinical Research Institute

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Neurology

Neurology, Epilepsy and Sleep

Center for the Study of Aging and Human Development

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

Duke - Margolis Center For Health Policy

Biostatistics & Bioinformatics, Division of Biostatistics

Published

171