Objective: To assess depressive symptom outcomes in a pooled sample of epilepsy self-management randomized controlled trials (RCTs) from the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB). Methods: Five prospective RCTs involving 453 adults with epilepsy compared self-management intervention (n = 232) versus treatment as usual or wait-list control outcomes (n = 221). Depression was assessed with the nine-item Patient Health Questionnaire. Other variables included age, gender, race, ethnicity, education, income, marital status, seizure frequency, and quality of life. Follow-up assessments were collapsed into a visit 2 and a visit 3; these were conducted postbaseline. Results: Mean age was 43.5 years (SD = 12.6), nearly two-thirds were women, and nearly one-third were African American. Baseline sample characteristics were mostly similar in the self-management intervention group versus controls. At follow-up, the self-management group had a significantly greater reduction in depression compared to controls at visit 2 (P <.0001) and visit 3 (P =.0002). Quality of life also significantly improved in the self-management group at visit 2 (P =.001) and visit 3 (P =.005). Significance: Aggregate MEW DB analysis of five RCTs found depressive symptom severity and quality of life significantly improved in individuals randomized to self-management intervention versus controls. Evidence-based epilepsy self-management programs should be made more broadly available in neurology practices.
Bibliographical noteFunding Information:
M.S. has research grants (within the past 3 years) from Otsuka, Alkermes, Janssen, Reuter Foundation, Woodruff Foundation, Reinberger Foundation, National Institutes of Health (NIH), CDC, and International Society of Bipolar Disorders. She has been a consultant to Bracket, Otsuka, Sunovion, Neurocrine, Supernus, and Health Analytics. She has received royalties from Springer Press, Johns Hopkins University Press, Oxford Press, and UpToDate. She has received compensation for continuing medical education activities with American Physician's Institute, MCM Education, CMEology, Potomac Center for Medical Education, Global Medical Education, and Creative Educational Concepts. R.T.F. is a consultant to UCB. B.C.J. has received research grant funding from the Diamond Foundation, Eisai, Medtronic, Neuropace, Sunovion, National Science Foundation, CDC, and Defense Advanced Research Projects Agency. T.M.S. has research grants (within the past 3 years) from UCB, Pfizer, NIH, CDC, and American Heart Association. C.T. has received research grants from the National Science Foundation and Biogen. None of the other authors has any conflict of interest to disclose. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Wiley Periodicals, Inc. © 2019 International League Against Epilepsy
- quality of life