Abstracts

Comprehensive treatment of epilepsy involves many facets including self-management behaviors. The most common self-management strategy is adherence to an antiepileptic drug (AED) regimen. Controlling other non-drug related factors, such as management of information, concern for personal safety, management of the seizures themselves, and lifestyle issues can also play a large role in the overall success of therapy. The purpose of this clinical study was to determine the relationship between self-management behaviors and clinical outcomes. Adult epilepsy patients whom were able to complete the surveys by themselves and had been taking AED therapy for at least 6 months were recruited from our outpatient epilepsy clinic for this cross-sectional, descriptive study. We used two previously-validated surveys to assess various self-management behaviors. Morisky[apos]s four-item self-reported adherence measure (not epilepsy-specific) and DiIorio[apos]s 38-item scale that assesses frequency of use of epilepsy self-management practices were administered to a random sample of patients. We also collected clinical (seizure activity, number of AEDs and presence/absence of toxicity) and demographic information. The response to the Morisky questions provides a score ranging from 1 to 4. A score of 1 categorizes the patient in the [quot]low[quot] medication-taking behavior category, a score of 2 or 3 is [quot]medium[quot] and 4 is [quot]high[quot] medication-taking behavior. On the Epilepsy self-management scale (ESMS), each item is rated on a 5-point scale ranging from 1=Never to 5=Always. Higher sores indicate more frequent use of self-management strategies. In addition, this scale can be divided into 5 subscales that address patient management of medication, information, safety, seizure and lifestyle. Data on eighteen patients (8 female, 10 male) has been collected to date. Their average age is 42.61 yrs (range 26-64). Patients were taking an average of 1.53 AEDs (range 1-2) as well as other prescription medications (median=2.5, range 1 to 18). Their monthly seizure burden ranged from seizure-free (n=7) to [quot]daily[quot] seizures (mean [plusmn] STD = 4.1 [plusmn] 10.45). Despite 7 patients acknowledging they have [quot]forgotten to take their medications[quot], the average Morisky Score had most of them in the [quot]High[quot] medication taking behavior category (3.39 [plusmn] 0.92). The average ESMS scores indicated frequent use of self-management strategies (3.62 [plusmn] 0.43). On our initial evaluation of this data, the medication-taking behavior did not predict the clinical outcomes. In our small sample of patients, we have found that it is not simply medication-taking behavior that influences seizure activity. Further exploration of the relationship between clinical outcomes and other non-drug self-management strategies is needed.