Abstracts

Rationale: More than half of patients with epilepsy experience cognitive challenges, including memory problems that can result in poor seizure monitoring and missed medications. Poor medication adherence is known to be a precipitant not only to seizures, but seizure related injuries and increased health care utilization. HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) is a telehealth delivered evidence-based program shown to significantly improve quality of life and address cognitive dysfunction (memory, attention, executive dysfunction) in adults with epilepsy. The current HOBSCOTCH III RCT includes feasibility testing of a streamlined smartphone app to collect daily participant logs reporting on seizure monitoring, medication adherence, use of learned memory strategies and a well-being rating scale.

Methods: This interim analysis uses data from adults (n=20; age range 22 - 65 years) with epilepsy enrolled in the HOBSCOTCH III RCT. All participants received a virtual 10-minute training on how to submit daily logs in the HOBSCOTCH app. Logs by app users included responses to four key questions; seizure occurrence (yes/no), medication adherence (yes/no), memory strategy use (yes/no), and well-being (Likert emoji rating scale). Daily smartphone reminder notifications to submit a log in the HOBSCOTCH App were sent at times set by the user to encourage consistent log submission. Participants enrolled in the RCT for less than 14 days excluded (n=3).

Results: Between November 2020 and the end of May 2021, participants submitted a total of 1430 logs, with an average of 83.4 (SD = 45.1) logs per participant. With participants enrolled in the RCT over time, an active period was defined for each participant as the days between their first and last log submitted, with the mean active period of 98.4 (SD = 50.8) days. Observing the log submission activity of participants, 94% of participant submitted logs for over half of the days during their active HOBSCOTCH app use period, and 82.4% of participants submitted logs for over 75% of their active period (Figure 1). Weighted means and confidence intervals for users’ monthly activity (i.e., percent of days in the month a log was submitted) reveal that participants on average submitted above 75% of days each month (Figure 2).

Conclusions: This interim analysis provides positive early data on the feasibility for people with epilepsy and cognitive challenges to consistently record daily logs on the HOBSCOTCH smartphone app. Developing an easy to use four-question tool and taking advantage of ubiquitous devices may assist patients in monitoring key disease variables and has the potential to augment disease self-management behaviors and improve health outcomes. These preliminary results demonstrate the HOBSCOTCH smartphone app holds promise in its utility to improve patient monitoring and reporting of key disease management variables to clinicians who care for people with epilepsy. Evaluation of the HOBSCOTCH app is ongoing.

Funding: Please list any funding that was received in support of this abstract.: Funding Source: Centers for Disease Control and Prevention U48 DP006377-01M001.