What question did this study set out to answer?

To assess the effects of service delivery, behavioural, and self-management interventions on seizure control and health-related quality of life in adults with epilepsy.

March 17, 2023Cochrane libraryOpen Access

Service delivery, behavioural, and self-management interventions for adults with epilepsy

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Authors

YHYun Huang NFNigel Fleeman ADAlison Jayne Doherty

Discussion

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Overview

Systematic review finds low- to moderate-certainty evidence for non-pharmacological interventions in adults with epilepsy, suggesting limited impact on seizure control and quality of life.

Key Points

To assess the effects of service delivery, behavioural, and self-management interventions on seizure control and health-related quality of life in adults with epilepsy.
Systematic review and meta-analysis of randomised controlled trials and quasi-RCTs identified via Cochrane Register of Studies, MEDLINE, and other databases up to August 21, 2023.
Included 36 studies with 5,834 participants aged 16 or older evaluating psycho-behavioural, mind-body, self-management, physical exercise, or service delivery interventions.
Assessed primary outcomes of seizure frequency and secondary outcomes including health-related quality of life (using QOLIE scales) with GRADE certainty assessments.
Psycho-behavioural interventions likely reduced seizure frequency at 3 to 6 months (mean reduction 4.42 per month, 95% CI 6.41 lower to 2.43 lower; 64 participants; moderate-certainty), but mind-body interventions showed low-certainty reductions at 6 to 8 weeks (mean reduction 3.28 per month, 95% CI 6.36 lower to 0.20 lower; 148 participants), and self-management showed no clear frequency reduction (mean 1.61 per month higher, 95% CI 6.08 lower to 9.29 higher; 222 participants).
Self-management interventions probably did not improve mean QOLIE-31 or QOLIE-31-P scores at 6 months (mean difference 2.42 higher, 95% CI 2.58 lower to 7.42 higher; 393 participants; moderate-certainty), and psycho-behavioural approaches produced no difference in QOLIE-10 at 6 months (mean difference 0.89 higher, 95% CI 1.06 lower to 2.84 higher; 120 participants; moderate-certainty).
No high-certainty evidence was identified for any intervention category, adverse events were not reported, and long-term outcome data beyond six months were largely lacking.

Cite This Study

Huang et al. (2023) studied this question.

synapsesocial.com/papers/6a7440fe0cd5a63ab398989b https://doi.org/10.1002/14651858.cd015284

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March 17, 2023Cochrane libraryOpen Access

Service delivery, behavioural, and self-management interventions for adults with epilepsy

View Full Paper

Ask AI

Bookmark

Authors

YHYun Huang NFNigel Fleeman ADAlison Jayne Doherty

Discussion

Member takes

Overview

Systematic review finds low- to moderate-certainty evidence for non-pharmacological interventions in adults with epilepsy, suggesting limited impact on seizure control and quality of life.

Key Points

To assess the effects of service delivery, behavioural, and self-management interventions on seizure control and health-related quality of life in adults with epilepsy.
Systematic review and meta-analysis of randomised controlled trials and quasi-RCTs identified via Cochrane Register of Studies, MEDLINE, and other databases up to August 21, 2023.
Included 36 studies with 5,834 participants aged 16 or older evaluating psycho-behavioural, mind-body, self-management, physical exercise, or service delivery interventions.
Assessed primary outcomes of seizure frequency and secondary outcomes including health-related quality of life (using QOLIE scales) with GRADE certainty assessments.
Psycho-behavioural interventions likely reduced seizure frequency at 3 to 6 months (mean reduction 4.42 per month, 95% CI 6.41 lower to 2.43 lower; 64 participants; moderate-certainty), but mind-body interventions showed low-certainty reductions at 6 to 8 weeks (mean reduction 3.28 per month, 95% CI 6.36 lower to 0.20 lower; 148 participants), and self-management showed no clear frequency reduction (mean 1.61 per month higher, 95% CI 6.08 lower to 9.29 higher; 222 participants).
Self-management interventions probably did not improve mean QOLIE-31 or QOLIE-31-P scores at 6 months (mean difference 2.42 higher, 95% CI 2.58 lower to 7.42 higher; 393 participants; moderate-certainty), and psycho-behavioural approaches produced no difference in QOLIE-10 at 6 months (mean difference 0.89 higher, 95% CI 1.06 lower to 2.84 higher; 120 participants; moderate-certainty).
No high-certainty evidence was identified for any intervention category, adverse events were not reported, and long-term outcome data beyond six months were largely lacking.

Cite This Study

Huang et al. (2023) studied this question.

synapsesocial.com/papers/6a7440fe0cd5a63ab398989b https://doi.org/10.1002/14651858.cd015284

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