Clinical Correlates of Epilepsy Self-management Competency Among Hispanic People with Epilepsy: Findings from the Managing Epilepsy Well (MEW) Network Integrated Database
Abstract number :
2.4
Submission category :
17. Public Health
Year :
2022
Submission ID :
2204656
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Ross Shegog, PhD – UTHealth School of Public Health, Houston; Omar Rosales, MPH – Baylor College of Medicine; Refugio Sepulveda, PhD – University of Arizona; Farren Briggs, PhD – Case Western Reserve University; Kaylee Sarna, MS – Case Western Reserve University; Brittany Brownrigg, BS, CCRP – University Hospitals Cleveland Medical Center; Tanya Spruill, PhD – NYU Grossman School of Medicine; Erica Johnson, PhD – University of Washington; Robert Fraser, PhD – University of Washington; Cam Escoffrey, PhD – Emory University; Barbara Jobst, MD – Geisel School of Medicine at Dartmouth; Elaine Kiriakopoulos, MD, MSc – Geisel School of Medicine at Dartmouth; Martha Sajatovic, MD – Case Western Reserve University
Rationale: Epilepsy self-management (ESM) by people living with epilepsy (PWE) is associated with greater epilepsy control, reduced seizure frequency, and increased QoL. PWE report more ESM behaviors for seizures and medication than other ESM domains (e.g. lifestyle, safety) and ESM is associated with demographic and clinical variables (e.g. age, depression). However, ESM among Hispanic PWE remains to be investigated. Small, disparate study samples that lack ESM measurement focus undermine meaningful empirical conclusions. The purpose of this study is to analyze aggregate data within the Managing Epilepsy Well Network Integrated Database (MEW-DB) to describe the 1) variability of ESM among Hispanic PWE and 2) the demographic and clinical variables most associated with ESM.
Methods: The analytic sample comprised Hispanic PWE (n=212) from 9 studies of 5 MEW interventions with common data elements of socio-demographics, clinical condition, and ESM behaviors (seizure, medication, lifestyle, safety, and information management domains). Measurement included clinical variables (overall health status, prior 30-day seizure occurrence, PHQ-9 and NDDI-E scale depression scores, and QOLIE-10), and ESM behavior (Epilepsy Self-management Scale). Analyses included descriptive and graphical comparison, correlation, and logistic regression.
Results: The sample was 39.3 (±12.8) years old, mainly female (56.1%), preferring Spanish language (59%), U.S. born (62.2%), white (44.8%), high school (34.1%) or college (31.8%) educated, single (43.9%) or married/partnered (41.0%), employed (33.0%) or unemployed (32.1%), and with income < $25,000 (59.0%). Most reported a seizure in the past 30 days (52.5%). Mean scores for PHQ-9 and NIDDI-E were 10.4 (±6.8) and 12.2 (± 4.4), respectively, (35.1% reached depression criteria) and QOLIE-10 was 30.0 (±7.9). The total ESM score for the pooled sample was 138.0 (± 15.7) and item mean score was 3.6 (± 0.4) on a 5-point response scale. Subscale scores (range 16.5± 5.4 - 36.0 ± 4.1), were highest for medication, seizure, and safety management (item mean score range 3.98-4.38) and lowest for information and lifestyle management (range 2.34-3.17). Higher ESM scores for medication, lifestyle, and information management were inversely associated with depression. In an adjusted multivariate model, medication management was associated with employment (retired) and inversely associated with marital status (never married) and depression. Lifestyle management was associated with employment (unable to work) and inversely associated with sex (female) and depression. Information management was associated with being born in the U.S.
Public Health