DGIM group in Annals IM: Self Management of Epilepsy

Wednesday, July 10, 2019

According to a systematic review published July 2, 2019, in the Annals of Internal Medicine, self-management strategies modestly improve the quality of life for adults with epilepsy, but are unlikely to reduce seizure rates. DGIM co-authors included Drs. Karen Goldstein, Jennifer Gierisch (secondary), Hayden Bosworth (secondary), and John Williams as senior author.

THE PROBLEM: does education about self-management help?

Patient self-management could be a help for primary care. The research team examined the components and efficacy of self-management interventions in the treatment of epilepsy in community-dwelling individuals. Data were reviewed from 13 randomized and two nonrandomized studies involving 2,514 patients.

FINDINGS: "Yes", a modest benefit

But, it depends of the type of self-management - educational or psychosocial. The team found that educational approaches may improve self-management practices and psychosocial therapy interventions may improve quality of life.

THE BOTTOM LINES FROM THE AUTHORS: 

  • Self-management support is beneficial for patients with chronic illness and is a sensible strategy for patients with epilepsy. It is a core component of patient centered care.
  • Studies in patients with epilepsy show some support for clinical benefit but the effects are small and vary by the type of self-management support given (educational versus psychosocial).
  • To fully understand the potential of self-management support, we need additional studies that incorporate input from patients and other stakeholders into the intervention design. Similarly, future research should involve intervention strategies that are designed to deliver self-management support that is tailored to the individual patient and evaluates effects on outcomes that are most important to patients and other stakeholders.

CITATION: 

Luedke MW, Blalock DV, Goldstein KM, Kosinski AS, Sinha SR, Drake C, Lewis JD, Husain AM, Lewinski AA, Shapiro A, Gierisch JM, Tran TT, Gordon AM, Van Noord MG, Bosworth HB, Williams, JW. Self-management of Epilepsy: A Systematic Review. Ann Intern Med. [Epub ahead of print 2 July 2019] doi: 10.7326/M19-0458 [Link]