Abstracts

The longitudinal effects of HOBSCOTCH—a self-management program for people with epilepsy.

Abstract number : 757
Submission category : 6. Cormorbidity (Somatic and Psychiatric)
Year : 2020
Submission ID : 2423096
Source : www.aesnet.org
Presentation date : 12/7/2020 9:07:12 AM
Published date : Nov 21, 2020, 02:24 AM

Authors :
Nicholas Streltzov, Dartmouth-Hitchcock Medical Center; Samantha Schmidt - Dartmouth-Hitchcock Medical Center; Wenyan Zhao - Dartmouth College; Robert Roth - Dartmouth-Hitchcock Medical Center; Lindsay Schommer - Dartmouth-Hitchcock Medical Center; Elaine


Rationale:
HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) is a behavioral intervention addressing cognitive dysfunction in adults with epilepsy. It has previously demonstrated efficacy in improving quality of life (QOL) and objective cognition. The current study presents longitudinal data from the multi-site, pragmatic replication trial.
Method:
Participants were block-randomized into three groups: in-person (HOB-IP, n=20), virtual treatment (HOB-V, n=17), or 6-month waitlist control (n=48). Participants were followed for 6-monthsafter completing the 12-week intervention. Groups were compared on measures of QOL (QOLIE-31), objective cognition (BTACTm), and subjective cognition (NeuroQOL-Cognitive Function), collected every three months.
Results:
This analysis focused on HOBSCOTCH in-person results. Differences between the in-person and virtual groups are discussed in another abstract.  HOB-IP, showed significant improvements in QOL compared to controls (p< 0.001) immediately post-intervention. Objective cognition remained unchanged, but self-reported cognitive function was improved following the intervention (p< 0.001). At 3 months post-HOBSCOTCH, overall QOL scores dropped from a 12.4 point treatment effect to a 5.2 point effect, which was not statistically significant compared to controls (p=0.1). NeuroQOL scores dropped from a 6.2 treatment effect to a 2.4 point effect (p=0.13).  A within-group analysis tracked outcomes out to 6 months post-intervention. Statistically significant improvements were seen in both QOL (p=0.002) and subjective cognition (p< 0.001) post-HOBSCOTCH compared to baseline. By 3 months post-treatment, subjective cognition scores were still improved (p=0.012), but overall QOL was not. At 6 months post, both outcome measures lost significance but remained elevated from baseline and appeared to stabilize.
Conclusion:
This is the first study to evaluate the longitudinal effects of HOBSCOTCH. While the intervention conveys significant short-term benefits, the effects diminished over time, suggesting that self-directed use of the program was uncommon. Because the biggest drop in overall QOL occurred3 months post-treatment, booster sessions may help sustain benefits. 
Funding:
:This study was funded by a grant from the Centers for Disease Control and Prevention
Comorbidity