Factors Contributing to Medication Adherence and Health Care Utilization in People with Epilepsy and Cognitive Challenges
Abstract number :
3.096
Submission category :
2. Translational Research / 2A. Human Studies
Year :
2022
Submission ID :
2205075
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Elaine Kiriakopoulos, MD, MSc – Dartmouth-Hitchcock Medical Center; Edward Camp, BA – Dartmouth-Hitchcock Medical Center; Channing George, BS – Dartmouth-Hitchcock Medical Center; Lisa Sackett, PhD – Dartmouth-Hitchcock Medical Center; Maureen Quigley, APRN – Dartmouth-Hitchcock Medical Center; Jane Vasquez, APRN – Dartmouth-Hitchcock Medical Center; Lindsay Schommer, APRN – Dartmouth-Hitchcock Medical Center; Suzanne Lenz, MA, CCRC – Dartmouth-Hitchcock Medical Center; Trina Dawson, BA – Dartmouth-Hitchcock Medical Center; Barbara Jobst, MD-PhD – Dartmouth-Hitchcock Medical Center
Rationale: Epilepsy is a spectrum disorder and people with epilepsy (PWE) are often confronted with complex medication regimens, cognitive and mental health comorbidities and increased risks for injury, hospitalization and death. Understanding complex relationships between variables in epilepsy and their impact on health behaviors, quality of life (QOL), seizure control and health care utilization is paramount to identifying opportunities for intervention. We leveraged baseline data collected from a national sample of PWE as part of the HOBSCOTCH 3 (Home Based Self-Management and Cognitive Training Changes Lives) RCT at Dartmouth.
Methods: Subjects (n=58) enrolled in HOBSCOTCH III RCT submitted baseline surveys, prior to intervention, for quality of life (QOLIE-31), depression (PHQ-9), cognitive function (Neuro-QOL), epilepsy self-management behaviors (AESMMI), medication adherence (MARS), and healthcare utilization (HCU). Data was stored in REDCap research database. Bivariate correlation analysis using Spearman’s Rho was calculated to report significant relationships between baseline QOL, depression, cognitive function, epilepsy self-management behaviors, and medical adherence (Table 2A). A separate bivariate correlation analysis using Spearman’s Rho was performed to find significant relationships between healthcare utilization, cognitive function, and medication adherence to primarily focus on questions from HCU (Table 2B).
Results: Between November 2020 and April 2022, subjects (n=58) were enrolled in the HOBSCOTCH III RCT and submitted baseline surveys (Table 1). Bivariate correlation analysis revealed significant negative correlations between depression and QOL, cognitive function, epilepsy self-management behaviors, and medication adherence (p < 0.001; p < 0.001; p=0.008; p=0.039, respectively). The analysis also highlighted significant positive correlations between QOL and cognitive function (p < 0.001), quality of life and medication adherence (p < 0.001), and cognitive function and medication adherence (p=0.029) (Table 2A). A separate bivariate correlation analysis (n=54) with an emphasis on HCU over the prior 6-months illustrates significant positive correlations between ER visits and overnight hospital stays (p < 0.001), as well as between physician visits and ER visits (p=0.026). A significant negative relationship between cognitive function and physician visits in the past 6-months was also demonstrated (p=0.003) (Table 2B).
Translational Research