Social Determinants of Health Impact Quality of Life in Children with Epilepsy
Abstract number :
2.365
Submission category :
17. Public Health
Year :
2021
Submission ID :
1826447
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:54 AM
Authors :
Christopher Beatty, MD - Nationwide Children's Hospital; Jaime Twanow – Nationwide Children's Hospital; Ammar Shaikhouni, MD, PhD – Nationwide Children's Hospital; Kristen Arredondo – Nationwide Children's Hospital; Stephanie Ahrens – Nationwide Children's Hospital; Nancy Auer – Nationwide Children's Hospital; Shivani Bhatnagar – Nationwide Children's Hospital; Molly Taylor – Nationwide Children's Hospital; Andrea Ganger – Nationwide Children's Hospital; Amy Wiens – Nationwide Children's Hospital; Adam Ostendorf – Nationwide Children's Hospital
Rationale: Health-related quality of life (HRQoL) in children with epilepsy (CWE) is a recommended metric for surveillance and assessing treatment outcomes.1 Factors such as sex, age, epilepsy characteristics, epilepsy treatments, comorbidities, parental characteristics, and socioeconomic status (SES) have been found to be associated with HRQoL in a meta-analysis.2 This study examines differences in HRQoL related to social determinants of health in order to identify areas for future intervention.
Methods: The PedsQL Epilepsy Module (PedsQLEp) was developed to be a reliable, sensitive, and practical tool to assess the spectrum of epilepsy.4 Responses are on a scale of 0-100 (100 being higher functioning) and evaluated in 5 domains: Impact (how much epilepsy affects daily activities), Cognitive (memory, ability to learn new materials), Sleep (fatigue), Executive (organization, impulsivity, inattention), and Mood (anger, sadness, frustration). Questionnaires were sent through the electronic medical record to children and their families prior to clinic visits or admissions to the epilepsy monitoring unit. Data collected over a 6-month period was included in this study. Comparisons of the five domains by sex, race, and insurance type were conducted through t-tests and analyzed using a Bonferroni correction for multiple comparisons.
Results: 389 independent responses were included in this study, mean age 11.6 years (SD 4.7). The mean of the five domains were: Impact 69.5 (SD 21.9), Cognition 48.4 (SD 29.3), Sleep 51.6 (SD 25.1), Executive 51 (SD 25.1), and Mood 58.2 (SD 22.3). There was not a significant difference in Impact, Cognition, Sleep, or Mood domains by sex (202 males, 187 females). The Executive domain was higher in females (54.6 vs 47.6, p = 0.01) but did not meet criteria for significance based on the Bonferroni correction. No differences were seen in any of the 5 domains regarding race (321 white, 68 non-white). Insurance comparisons of commercial vs publicly-funded demonstrated significant differences in Impact (72.5 vs 64.9, p=0.0008), Cognition (51.9 vs 42.7, p=0.0023), and Executive (55.5 vs 44.1, p< 0.0001) with Commercial insurance having higher values (211 Commercial, 159 Publicly-funded).
Public Health