DETERMINANTS OF HEALTH-RELATED QUALITY OF LIFE IN NEWLY DIAGNOSED SEIZURES
Abstract number :
2.020
Submission category :
Year :
2003
Submission ID :
3872
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
David M. Ficker, Cynthia Hughes, Rakesh Shukla, Michael D. Privitera Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH; Department of Environmental Health, University of Cincinnati Medical Center, Cincinnati, OH
To determine factors that contribute to health-related quality of life (HRQOL) in patients with newly diagnosed seizures.
We prospectively measure the QOLIE-89, Profile of Mood States (POMS), Adverse Events Profile and the Epilepsy Foundation Concerns Index in patients within three months of a single seizure or new diagnosis of epilepsy. Serial measures are performed every four months. Inclusion criteria are: age between 18-64, able to read and speak English and a minimum tenth grade education. Exclusion criteria are: inability to complete forms, presence of other neurologic or medical disorders that may affect HRQOL, prior craniotomy and use of medications that can affect the central nervous system (other than AEDs). The primary outcome measure was QOLIE-89 overall score. Variables analyzed included: age, gender, average monthly seizure frequency, profile of mood states subscales (depression/dejection, tension/anxiety, fatigue/inertia, confusion/bewilderment, anger/hostility, and vigor/activity) the Epilepsy Foundation of America (EFA) score and the adverse events profile (AEP) score. An initial bivariate correlation analysis was performed. Stepwise linear regression was performed to determine which factors independently correlate with overall QOL.
Bivariate analysis revealed that seizure frequency, POMS subscales (tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia and confusion/bewilderment), EFA score and AEP were negatively correlated (P[lt] 0.05) with overall QOL. The POMS subscale of vigor/activity was, however, positively correlated with overall QOL (P[lt] 0.001). Multiple Linear Regression revealed that AEP score (P=0.006) and seizure frequency (P=0.02) were independent predictors of the overall QOL. Vigor/activity was an independent and positive correlate of the overall QOL (P=0.02). Partial R-square values for each significant predictor of the overall QOL are summarized in the table.
These preliminary results suggest that medication side effects are the most important determinant of the variability in HRQOL in patients with recently diagnosed seizures.[table1]
[Supported by: NINDS 5K23NS002170]