Altaf Saadi1, Bryan Patenaude2, Damber Kumar Nirola3, Sonam Deki4, Lhab Tshering5, Sarah Clark6, Lance Shaull7, Tali Sorets8, Guenther Fink9, Farrah Mateen10. 1. Partners Neurology Residency, Massachusetts General Hospital and Brigham and Woman's Hospital, Boston, USA. Electronic address: asaadi@partners.org. 2. Harvard T. H. Chan School of Public Health, Boston, USA. Electronic address: bryanpatenaude@gmail.com. 3. Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. Electronic address: drnirola@yahoo.com. 4. Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. Electronic address: somkey90@gmail.com. 5. Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. Electronic address: tsheringlhab999@gmail.com. 6. Massachusetts General Hospital, Boston, USA. Electronic address: sclark0929@gmail.com. 7. Massachusetts General Hospital, Boston, USA. Electronic address: lrshaull@gmail.com. 8. Massachusetts General Hospital, Boston, USA. Electronic address: tsorets@bbns.org. 9. Harvard T. H. Chan School of Public Health, Boston, USA. Electronic address: gfink@hsph.harvard.edu. 10. Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, USA. Electronic address: fmateen@mgh.harvard.edu.
Abstract
PURPOSE: To assess the quality of life in epilepsy (QOLIE) among adults in the lower middle-income country of Bhutan and assess the potential demographic and clinical associations with better QOLIE. METHODS: People with clinically diagnosed epilepsy were prospectively enrolled at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu (2014-2015). Regression models were constructed to assess the potential impact of age, sex, residence in the capital city, wealth quintile, educational attainment, seizure in the prior year, seizures with loss of consciousness, self-reported stigma score, and need for multiple antiepileptic drugs. RESULTS: The mean Bhutanese 48.4/100 ± 17.3 [corrected] score among 172 adults (mean age 31.1 years, 93 female) was 48.9/100±17.7. Younger age, lower educational attainment level, and increased self-perceived stigma were each observed to have an independent, negative association with QOLIE (p<0.05), while a patient's wealth quintile, sex, seizure frequency, seizure type and number of antiepileptic drugs were not. Education appeared to be most strongly associated with QOL at the high school and college levels. CONCLUSIONS: There are potentially modifiable associations with low QOLIE. Addressing the educational level and self-perceived stigma of PWE may have an especial impact. The low QOLIE in Bhutan may reflect cultural approaches to epilepsy, health services, or other factors including those outside of the health sector.
PURPOSE: To assess the quality of life in epilepsy (QOLIE) among adults in the lower middle-income country of Bhutan and assess the potential demographic and clinical associations with better QOLIE. METHODS:People with clinically diagnosed epilepsy were prospectively enrolled at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu (2014-2015). Regression models were constructed to assess the potential impact of age, sex, residence in the capital city, wealth quintile, educational attainment, seizure in the prior year, seizures with loss of consciousness, self-reported stigma score, and need for multiple antiepileptic drugs. RESULTS: The mean Bhutanese 48.4/100 ± 17.3 [corrected] score among 172 adults (mean age 31.1 years, 93 female) was 48.9/100±17.7. Younger age, lower educational attainment level, and increased self-perceived stigma were each observed to have an independent, negative association with QOLIE (p<0.05), while a patient's wealth quintile, sex, seizure frequency, seizure type and number of antiepileptic drugs were not. Education appeared to be most strongly associated with QOL at the high school and college levels. CONCLUSIONS: There are potentially modifiable associations with low QOLIE. Addressing the educational level and self-perceived stigma of PWE may have an especial impact. The low QOLIE in Bhutan may reflect cultural approaches to epilepsy, health services, or other factors including those outside of the health sector.
Authors: Jeremy C Kane; Melissa A Elafros; Sarah M Murray; Ellen M H Mitchell; Jura L Augustinavicius; Sara Causevic; Stefan D Baral Journal: BMC Med Date: 2019-02-15 Impact factor: 8.775