Abstracts

Rationale: We initiated this study in order to assess clinical factors influencing health-related quality of life (HRQL) in Japanese patients with epilepsy, and the results are anticipated to highlight the importance of HRQL in treatment and management of epilepsy.Methods: In the present study, the HRQL scores of 599 patients belonging to the Japanese Epilepsy Association (16 years old or more) were evaluated using a self-administered QOL questionnaire, entitled quality of life in epilepsy (QOLIE-31). To explore factors influencing on HRQL in patients with epilepsy, a stratified analysis employing various factors such as the patient's demographic characteristics (age and gender), social status (occupation), the frequency and severity of seizures, the ictal and post-ictal symptoms, co-morbidities, and medications.Results: The mean patient age was 37.2 (SD 11.6) years; 49.9% were female. The mean duration of epilepsy was 28.8 (SD 12.1) years. Mean scores in domains of the QOLIE-31 ranged from 46.4 to 60.9; hence in Japanese patients with epilepsy HRQL scores of the 7 remaining domains ( “Seizure worry: SW”, “Overall quality of life: OQ”, “Emotional well-being: WE”, Cognitive functioning: CF”,” Medical effects: ME”, ”Social functioning: SF”, and “Overall score: OS” ), the exception being “Energy/fatigue: EF”, were lower than those reported by Vickrey et al in the US. Cronbach α coefficients ranged 0.747 to 0.891; hence the QOLIE-31 was demonstrated to be highly reliable in Japanese patients. The frequency, management status, and severity of seizures were assumed to be independent variables. As for three the seizure designations of “remarkable”, “unremarkable', and “during sleep”, significant changes in the HRQL score were noted in the first 2. Regarding the seizures which occurred during sleep, there were no the HRQL scores of any domains which tended to be significant among the categories. Furthermore, from a clinical perspective, employment status, disturbance of intelligence, the efficacy of surgery, and number of anti-epilepsy drugs, duration of unconsciousness, frequency of injuries and fall during seizures, status of post-ictal confusion and the recovery time after seizure, factors other than frequency, control status, and the severity of seizures have been suggested as factors influencing QOLs in Japanese patients with epilepsy (ANOVA: p<0.01-0.000).Conclusions: In exploring the factors influencing the HRQL of Japanese patients with epilepsy in this study, we found that their QOLs were only improved in the absence of remarkable seizures for two years or more, whereas we can expect that the lower frequency of unremarkable seizures were, the higher QOLs were. The seizures which occur during sleep might have no influence on QOL. Thus, the present study revealed decreased QOLs in Japanese patients with epilepsy to be attributable to various factors. To improve their QOLs, it is, therefore, necessary that patients with epilepsy receive comprehensive care.