Real World Application: Assessing Quality of Life Benefits from a Cognitive Epilepsy Self-management Program
Abstract number :
3.097
Submission category :
2. Translational Research / 2A. Human Studies
Year :
2022
Submission ID :
2205098
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Channing George, BS – Dartmouth-Hitchcock Medical Center; Elaine Kiriakopoulos, MD, MSc – Dartmouth-Hitchcock Medical Center; Edward Camp, BA – Dartmouth-Hitchcock Medical Center; Trina Dawson, BA – Dartmouth-Hitchcock Medical Center; Lisa Sackett, PhD – Dartmouth-Hitchcock Medical Center; Maureen Quigley, APRN – Dartmouth-Hitchcock Medical Center; Anna Murray, BA – Dartmouth-Hitchcock Medical Center; Carly Sykes, MPH – Dartmouth-Hitchcock Medical Center; Suzanne Lenz, MA – Dartmouth-Hitchcock Medical Center; Barbara Jobst, MD-PhD – Dartmouth-Hitchcock Medical Center
Rationale: Interest among clinical providers for psychological interventions in the care of people with epilepsy (PWE) continues to expand. Evidence-based epilepsy self-management (ESM) programs have demonstrated the ability to assist with improving quality of life (QOL) and seizure related outcomes and decreasing comorbid cognitive and mental health challenges in PWE. In order for these programs to fully manifest as a support for PWE and an adjunct to care for providers to offer their patients, the benefits of these programs need to be demonstrated through real world implementation. The HOBSCOTCH (HOme Based Self-Management and COgnitive Training CHanges Lives) program has previously been shown to improve QOL in two RCTs via both in person and virtual delivery methods.
Methods: Translation from randomized controlled trial delivery to real world delivery of the HOBSCOTCH program was evaluated at Dartmouth Health’s Epilepsy Center/HOBSCOTCH Institute from January 2020 through April 2022. HOBSCOTCH program availability was disseminated via websites (managingepilepsywell.org, HOBSCOTCH.org), community serving organizations and epilepsy centers nationwide engaged in partnered referral to make the HOBSCOTCH telehealth deliverable program accessible to PWE. The HOBSCOTCH Institute trained and hired Cognitive Coaches (psychologist, APRN, CHW, MPH) to meet program referral demand. PWE interested in receiving the program underwent a prescreen with a program coordinator prior to being connected with a Cognitive Coach for the intervention.
Results: A total of 241 referrals (55% clinician referral; 29% self-referred; 12% community referral; 4% family member referral; 69% urban/31% rural dwelling) were made to the HOBSCOTCH Institute from 45 states. 25% of PWE referred expressed interest in participating in epilepsy research and were enrolled in the HOBSCOTCH-3 RCT. The remaining participants were included in the “general delivery” stream. HOBSCOTCH program evaluation questionnaires, including the Pre QOLIE-10, Post QOLIE-10, and satisfactions surveys were completed by 55% of all participants. Pre- and Post- HOBSCOTCH QOLIE-10 data demonstrated a significant improvement in quality of life (Figure 1). A Wilcoxon signed-rank test was performed to assess the difference in QOLIE scores before (3.04 ± 0.09) and after (2.57 ± 0.10) intervention for our sample population (n=67; 95% CI), which we found to be significant (p < 0.001). A dependent paired t-test also yielded p < 0.001.
Translational Research