Abstracts

Rationale: Over half of adults with epilepsy experience cognitive difficulties and feel that seizures interfere with memory. An evidence-based self-management program, HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) was developed to address these challenges and showed improvement in quality of life and attention when delivered in single center and multicenter pragmatic studies across the Northeastern United States^{1, 2}. Participants were recruited from clinical settings and local community organizations. HOBSCOTCH, delivered through eight sessions with certified Cognitive Coaches, has proven effective in enhancing quality of life, attention, and memory. In this study, we report baseline data from patients enrolling in a replication study intended to reach a wider population of participants living with epilepsy in Georgia.

Methods: A total of 84 participants were consented and enrolled in the HOBSCOTCH Replication trial based in Georgia. 52 were recruited from clinical settings for a clinical trial and 32 recruited from epilepsy-serving community organizations and clinical settings for a community trial. Participants were randomly assigned to the treatment group or the waitlist control group. Demographic data, medical history, Quality of Life in Epilepsy (QOLIE-31), Patient Health Questionnaire (PHQ-9), Quality of Life in Neurological Disorders (Neuro-QOL), the Adult Epilepsy Self-Management Measurement Instrument (AESMMI-65), and Medication Adherence Report Scale (MARS) were measured at baseline.

Results: Two-thirds (66.7%) of participants (n=84) in the clinical and community trials were female, over half (61.9%) were white, about one third (34.5%) were black with the remaining 1.2% being Asian. 54.8% reported being college graduates, and 42.9% had an income over $50,000. The average age of participants was 46.7 years with the average age of diagnosis being 28.4 years. Over half reported having focal onset seizures (54.8%) and having a seizure within the past 12 months (69.0%). Participants scored moderately on the QOLIE-31 (M=46.89), with a moderate risk of depression as indicated on the PHQ-9 (M=10.94) and an average quality of life for neurological conditions based on the Neuro-QOL (M=57.86). Additionally, participants reported practicing self-management behaviors at moderate frequency for the 12 domains measured on the AESMMI-65 which included medication adherence (M=3.53). Moderate frequency of medication adherence was reported through the MARS scale (M=3.13).

Conclusions: In this study, women were more likely to enroll than men though the reasons for this are unclear. Interestingly, participants had moderate to average quality of life scores and moderate risk of depression. This may indicate that despite memory concerns leading them to the program, other aspects of neurologic health may be somewhat preserved. Future work in this study will determine the impact of the HOBSCOTCH program on this population of participants.

Funding: Centers for Disease Control and Prevention U48 DP006377-04-00.