Martha Sajatovic1,2,3,4, Erica K Johnson5, Robert T Fraser6, Kristin A Cassidy1,2,3,4, Hongyan Liu2,3,4, Dilip K Pandey7, Rakale C Quarells8, Peter Scal9, Samantha Schmidt10, Ross Shegog11, Tanya M Spruill12, Mary R Janevic13, Curtis Tatsuoka2,3,4, Barbara C Jobst10. 1. Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio. 2. Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio. 3. Case Western Reserve University School of Medicine, Cleveland, Ohio. 4. Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio. 5. Health Promotion Research Center, University of Washington, Seattle, Washington. 6. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington. 7. Department of Neurology and Rehabilitation, University of Illinois College of Medicine at Chicago, Chicago, Illinois. 8. Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia. 9. Department of Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota. 10. Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, New Hampshire. 11. University of Texas Health Science Center at Houston School of Public Health, Houston, Texas. 12. Department of Population Health, New York University School of Medicine, New York, New York. 13. Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Michigan.
Abstract
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. Wiley Periodicals, Inc.
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. Wiley Periodicals, Inc.
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