Clinic-based Decision Support for Epilepsy Self-management: Preliminary findings from the MINDSET 2.0 Efficacy RCT.
Abstract number :
2.133
Submission category :
17. Public Health
Year :
2025
Submission ID :
485
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Ross Shegog, PhD – UTHealth Houston School of Public Health
Refugio Sepulveda, PhD – University of Arizona
Robert Addy, PhD. – UTHealth Houston
Katarzyna Czerniak, MLA, MPH, PhD – UTHealth Houston School of Public Health
Kim Martin, BA – Epilepsy Foundation Central South Texas
Suja Rajan, PhD. – UTHealth School of Public Health
David Labiner, MD – University of Arizona
Rationale: The Management Information & Decision Support Epilepsy Tool (MINDSET) provides bilingual digital support to enhance the epilepsy self-management (ESM) of people with epilepsy (PWE) through tailored goal-based action planning. An upgraded version (MINDSET 2.0) provides enhanced cross-platform accessibility, recommendations for evidence-based ESM Managing Epilepsy Well programs (PACES, UPLIFT, HOBSCOTCH) tailored to patient data, and assessment and feedback on social determinants of health (SDOH). Purpose: To assess the efficacy of MINDSET 2.0 to improve ESM adherence, depression symptoms, quality of life (QOL), and SDOH.
Methods: Adult PWEs (n=119) from Epilepsy Foundation Central & South Texas (n=3) and Banner University Medical Center (n=2) clinics were randomly assigned to treatment (MINDSET 2.0 plus usual care) or comparison (usual care only) conditions (n=63 and n=56 respectively) and followed for two clinic visits from August, 2023 through May, 2025. Participants completed a demographic survey and embedded scales within MINDSET to assess ESM (ESM Survey), depressive symptoms (NDDI-E), QOL (QoLIE-10), and SDOH (Health Leader; HL). Treatment condition participants also selected three ESM behavioral goals and related strategies and received a printed Action Plan to discuss with their HCP. Comparison condition participants did not receive ESM feedback, select goals and strategies, or receive an Action Plan. Instead, they continued with their regular clinic visit. Preliminary unadjusted linear regression analyses were conducted to explore between-group differences for the ESMS, QOLI-E, NDDI-E, and HL.
Results: Patient characteristics: At baseline participant PWE were 20-79 yrs. (mean 46±14.3), mostly female (65%), of Mexican origin (81.6%), with some college education (70%), mostly single or separated (58%), employed (53%), earning below $50K (65%), and seizure free since their last neurology visit (66%). The time between baseline (visit 1) and follow-up (visit 2) ranged from three to 19 months (mean 293.4±125.9 days). Participant retention by visit 2 was 102 (86%) comprising 56 treatment and 46 participants respectively. Treatment and comparison groups were demographically equivalent. Primary outcomes: Changes in mean scale scores (ESMS, NDDI-E, QOLIE-10) between baseline and follow-up visits for each study cohort were analyzed. Between group comparison showed that MINDSET significantly improved ESM lifestyle activities (p< 0.05). These comprise strategies to get adequate sleep, reduce staying out late, manage stress, engage in relaxation to avoid seizures, optimize exercise and healthy diet. Improvement of depression symptoms approached significance (p=0.07). Change in between group QOLIE-10 scale scores and HL frequencies were not significant.
Public Health