Abstracts

Rationale: Epilepsy self-management issues for adults include limited knowledge about the disorder, treatment, and consequences; psychosocial aspects (anxiety, depression, social stigma, cognition), and community adjustment. Self-management interventions provide patient education to improve patients' medical, role, and emotional management, thereby reducing healthcare utilization. Previous interventions were developed based on expert opinion, indicated issues with participant engagement/retention, and reported limited follow-up periods. PACES In Epilepsy addressed methodological concerns by utilizing patient needs assessment data (n=165) to derive self-management content and program design features for evaluation in a randomized controlled trial (RCT). Methods: Participants were adults age 18+ with chronic epilepsy (n=83), free of serious/persistent mental illness and substantive intellectual impairment, and recruited from 2 epilepsy clinics. Upon enrollment, participants were randomly assigned to the intervention or control (treatment as usual) group. Outcome measures included the Epilepsy Self-Management Scale, Epilepsy Self-Efficacy Scale, QOLIE-31, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7. They were administered at baseline, post-intervention (8 weeks), and 6 months post-intervention. The intervention was an 8-week group co-lead by a psychologist and trained peer with epilepsy. Groups had 6-8 adults with epilepsy, met one evening peer week at a hospital for 75 minutes, and addressed the following topics: Epilepsy and Medical Issues; Dealing with Stress and Sadness; Optimizing My Cognition; Community Participation on a Budget; Managing My Epilepsy Care; Assertive Communication; and My Health and Well-Being. The treatment group formulated and rated weekly treatment goals based on Goal Attainment Scaling, and provided satisfaction ratings relative to program features (topics, leadership, format). Results: Preliminary t-tests confirmed equivalent groups in terms of demographic variables, seizure features, and baseline scores (see Table 1). Regarding main outcomes, PACES participants (n=41) improved relative to controls (n=42) on the ESSM (p<