Clinical correlates of epilepsy self-management adherence among Hispanic people with epilepsy: Findings from the managing epilepsy well (MEW) network integrated database

Background

Epilepsy self-management (ESM) by people living with epilepsy (PWE) can reduce seizure frequency and increase quality of life (QOL). ESM among Hispanic PWE is under-investigated and lacks adequate sampling and ESM assessment. The purpose of this study was to assess ESM and associated variables among Hispanic PWE using aggregate data from the Managing Epilepsy Well Network Integrated Database.

Methods

The sample comprised Hispanic PWE (n = 211) from nine ESM intervention studies that used common measures for socio-demographics, health status, prior 30- day seizures, depression (PHQ-9, NDDI-E), QOL (QOLIE-10), and ESM.

Results

The sample was 39.3 (±12.8) years, mostly female (56.1 %), preferring Spanish language (59 %), U.S. born (62.2 %), high school or college educated (35.7 %), single/partnered (43.9 %/41.0 %), employed/unemployed (33.0 %/32.1 %), with income <$25,000 (59.0 %), with depressive symptoms (35.1 %), and a seizure in the past month (52.5 %). Total ESM item mean scores were positively skewed (3.6 ± 0.4 on a 5-point scale). Medication, seizure, and safety management exceeded that for information and lifestyle management. In adjusted multivariable models, medication management was associated with age and employment (homemaker) and inversely associated with marital status (never married) and depression. Lifestyle management was associated with employment (unable to work) and inversely associated with sex (female), depression, and QOL.

Conclusion

Hispanic PWE were more competent in managing the medical aspects of their condition than lifestyle and informational issues. This study is significant because it leverages the analytic power of a large aggregate Hispanic PWE sample to describe ESM and can inform future study design, data collection, and tailoring of ESM interventions.