Effectiveness of HOBSCOTCH, a Self-management Program to Improve Cognitive Function and Quality of Life, in the Georgia Replication Trial
Abstract number :
1.408
Submission category :
17. Public Health
Year :
2023
Submission ID :
640
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Katie Bullinger, MD/PhD – Emory University
Jerik Leung, MPH – Emory University; Taylor Shade, BS – Emory University; Archna Patel, MPH – Emory University; Barbara Jobst, MD/PhD – Dartmouth-Hitchcock Medical Center; Elaine Kiriakopoulos, MD/MSc – Dartmouth-Hitchcock Medical Center; Cam Escoffery, PhD – Emory University
Rationale: Cognitive difficulties are common among persons living with epilepsy. Home Based Self-Management and Cognitive Training Changes Lives (HOBSCOTCH), a self-management program aimed at improving cognitive function and quality of life, has been shown to be effective in single center and multicenter pragmatic studies in epilepsy centers across the Northeastern United States (Caller et. al 2016, Streltzov et. al 2022). In this study, we examine the effectiveness of the HOBSCOTCH program in a single center, pragmatic replication trial at a large urban academic center in Atlanta, Georgia.
Methods: Subjects were recruited from Emory University’s Comprehensive Epilepsy Center. Subjects were randomized to intervention with the HOBSCOTCH cognitive therapy program or the waitlist control group. Demographic and seizure information was collected at baseline. Outcomes measures including Quality of Life in Epilepsy v1.0 (QOLIE-31), Quality of Life in Neurologic Disorders v2.0-Cognitive Function (Neuro-QOL), and Patient Health Questionnaire-9 (PHQ-9) were collected at baseline and at 3-months (immediately post intervention for the treatment group). Outcomes were assessed with two-way ANOVA analyses using PROC MIXED in SAS 9.4 using restricted maximum likelihood estimation. For each outcome (QOLIE-31, Neuro-QOL, PHQ-9), we analyzed the interaction of time and treatment group and provided simple main effects by treatment group for those outcomes with significant interactions of independent factors.
Results: A total of 59 subjects were enrolled in this study. One subject was excluded from the present analysis due to not having completed the baseline assessment. A total of 30 subjects were randomized into the HOBSCOTCH treatment and 28 participants into the waitlist condition. A total of 42 participants (18 in HOBSCOTCH group, 24 in waitlist group) had completed their three month assessment and 40 participants were included in analysis. Participant demographics at baseline are reported in Table 1. The results of the two-way ANOVA are reported in Table 2. For QOLIE-31 and Neuro-QOL, there were significant interactions of independent factors (QOLIE-31: F=7.52, p=0.009; Neuro-QOL: F=5.34, p=0.026). In addition, simple main effects analyses showed significant increases in mean scores for both outcomes within HOBSCOTCH treatment group at three months versus baseline (QOLIE-31: F=7.83, p=0.008; Neuro-QOL: F=8.02, p=0.007). For depression (PHQ-9), the interaction of independent factors was not significant. Main effects suggested no difference in PHQ-9 score related to treatment group or time.
Conclusions: These data support improvements in both neurological health and quality of life scores, but not depression scores, immediately following HOBSCOTCH intervention among patients in an urban and southern comprehensive epilepsy center. Future analyses will examine if the observed effects persist over time and are maintained after full intervention participation.
Funding: Funding for this work was provided by Centers for Disease Control and Prevention U48 DP006377-04-00.
Public Health