Abstracts

The Feasibility and Utility of an Epilepsy Self-management Mobile App to Improve Health Behaviors and Outcomes

Abstract number : 3.149
Submission category : 2. Translational Research / 2E. Other
Year : 2022
Submission ID : 2205034
Source : www.aesnet.org
Presentation date : 12/5/2022 12:00:00 PM
Published date : Nov 22, 2022, 05:27 AM

Authors :
Edward Camp, BA – Dartmouth-Hitchcock Medical Center; Elaine Kiriakopoulos, MD, MSc – Dartmouth-Hitchcock Medical Center; Lisa Sackett, PhD – Dartmouth-Hitchcock Medical Center; Maureen Quigley, APRN – Dartmouth-Hitchcock Medical Center; Trina Dawson, BA – Dartmouth-Hitchcock Medical Center; Channing George, BS – Dartmouth-Hitchcock Medical Center; Suzanne Lenz, MA – Dartmouth-Hitchcock Medical Center; Barbara Jobst, MD-PhD – Dartmouth-Hitchcock Medical Center

Rationale: HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) is an evidence-based intervention shown to improve quality of life and cognitive function in adults with epilepsy and delivered one-to-one by a trained Cognitive Coach. Mobile app use in health care is expanding to promote changes in health behaviors and improve patient outcomes.  In the current iteration (HOB-III) of the HOBSCOTCH program, participants are asked to answer daily logs on a mobile HOBSCOTCH app they download to their smartphone. We aim to examine the potential for the HOBSCOTCH app to assist in driving improvements related to key outcomes including seizure frequency and medication adherence.

Methods: This interim analysis uses survey and app data from 25 adults with epilepsy enrolled in the HOBSCOTCH 3 trial and completed the 9-week intervention. All participants were trained to submit daily logs in the HOBSCOTCH app, responding to questions regarding seizure occurrence, medication intake, memory strategy usage, and well-being. Participants were sent a single daily HOBSCOTCH app notification to encourage consistent log submission. Additional support and technical app assistance was provided by study coordinators if a significant decline in log submissions was noted. Additional data gathered in this cohort included, Quality of life (QOLIE-31), depression (PHQ-9), cognitive function (Neuro-QOL), epilepsy self-management behaviors (AESSMI), and medication adherence (MARS) questionnaires pre and post the 9-week intervention.

Results: Participants’ app activity during the 9-week intervention revealed 44% of participants submitted logs over 90% of days and 80% of participants submitted logs for over 50% of days. Bivariate correlations using Spearman’s rho were calculated using submitted logs and participants’ app activity, yielding a significant negative correlation between seizure occurrences and well-being [rho = -0.451 p = 0.024], and between seizure occurrences and self-reported medication intake [rho = -0.421, p = 0.036]. While other correlations did not yield significant results, a larger sample size could elucidate significance for desirable relationships, such as the positive correlation between app activity and both medication intake and memory strategy usage (Table 1). In this cohort of app users, comparing survey data before and after the 9-week program, participants showed significant improvements in quality of life (QOLIE-31) [p=0.001], improvements in cognitive function (Neuro-QOL) [p=0.006], and increased usage of self-management memory strategies (AESMMI) [p=0.014] (Figure 1).

Conclusions: This interim analysis continues to support good user engagement with an epilepsy self-management phone app and feasibility for allowing people to record daily logs consistently. Although our findings are promising, a larger sample is required to confirm and achieve significance for these early correlations. Nonetheless, these preliminary results demonstrate PWE are amenable to using an app with the potential to drive improved health behaviors and outcomes.

Funding: Centers for Disease Control and Prevention U48 DP006377 - SIP 19-002
Translational Research