Author ORCID Identifier
Document Type
Article
Publication Date
5-23-2025
Abstract
Objectives: This 2-site, 6-month randomized controlled trial of an epilepsy self-management (ESM) curriculum (SMART) vs. 6-month waitlist (WL) control assessed effects on epilepsy outcomes in 160 people with epilepsy (PWE). Methods: PWE had at least 1 negative health event (NHE) defined as a seizure, emergency department visit, hospitalization or self-harm attempt in the last 6 months. Primary outcomes were differences in proportions of PWE with reductions in NHEs from baseline to 6 months follow up and change in NHE/seizure counts between SMART and WL. Secondary outcomes included the Patient Health Questionnaire (PHQ-9), 36-Item Short Form Survey (SF-36), Quality of Life in Epilepsy (QOLIE-31), Epilepsy Self-Management Scale (ESMS), Epilepsy Stigma Scale (ESS), Multidimensional Scale of Perceived Social Support (MSPSS) and Epilepsy Self-Efficacy Scale (ESES). Results: Mean age was 39.4 (SD 12.2), 66.9 % (N = 107) women, and 31 % (N = 50) rural. Mean PHQ-9 of 10.5 (SD 7) suggested mild/moderate depression. Seizures were the most common NHE with mean baseline past 6-month seizure count of 20.6 (SD 41.0). SMART was significantly associated with a 2-fold increase in odds of having at least 10–30 % improvement in NHEs vs. WL (p < 0.05). SMART was associated with significant seizure reduction (p < 0.05), significantly improved PHQ-9 (p = 0.014), QOLIE-31 seizure worry (p = <0.001) and social functioning (p = 0.021), ESES (p = 0.046) and ESMS (p < 0.001). Significance: Compared to WL, SMART participants had improvement in NHEs and seizures, depressive symptoms, self-management competency and self-efficacy and selected elements of quality of life. Inclusion of effective ESMs into a comprehensive care of model for PWE may be warranted.
Keywords
depression, epilepsy, quality of life, seizures, stigma
Language
English
Publication Title
Epilepsy and Behavior
Rights
© 2025 The Authors. This is an open access work distributed under the terms of the Creative Commons Attribution-Non-Commercial (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Sajatovic, Martha; Black, Jessica; Krehel-Montgomery, Jacqueline; Barigye, Richard; Yala, Joy; and Adeniyi, Clara, "Self-Management for People with Epilepsy and a History of Negative Health Events (Smart): A Randomized Controlled Effectiveness Trial" (2025). Faculty Scholarship. 1386.
https://commons.case.edu/facultyworks/1386
Manuscript Version
Final Publisher Version