Limited evidence suggests that self-management strategies modestly improve some outcomes among persons with epilepsy, according to a review published in the Annals of Internal Medicine. Matthew W. Luedke, M.D., from the Duke University Medical Center in Durham, North Carolina, and colleagues examined the components and efficacy of self-management interventions in the treatment of epilepsy in community-dwelling individuals. Data were reviewed from 13 randomized and two nonrandomized studies involving 2,514 patients.
The researchers found that interventions were mainly delivered in group settings and employed a median of four components following two general strategies: one based on education and one on psychosocial therapy. Self-management behaviors were improved with education-based approaches (standardized mean difference, 0.52), while quality of life was improved with psychosocial therapy-based approaches (mean difference, 6.64). Self-management interventions did not reduce seizure rates, while a composite of seizures, emergency department visits, and hospitalizations was reduced with one educational intervention.
“These self-management approaches showed clinically important benefit for only a few outcomes, but the confidence in these findings was mostly low,” the authors write. “Further, the effect of educational interventions on quality of life and self-efficacy varied inexplicably.”
Several authors disclosed financial ties to the pharmaceutical industry.