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- Hamedi-Shahraki, Soudabeh, et al.
(författare)
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Health-related quality of life and medication adherence in elderly patients with epilepsy.
- 2019
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Ingår i: Neurologia i Neurochirurgia Polska. - : Via Medica. - 0028-3843 .- 1897-4260. ; 53:2, s. 123-130
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics.METHODS: In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up.RESULTS: Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test.CONCLUSION: This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.
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| 2. |
- Hamedi-Shahraki, Soudabeh, et al.
(författare)
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Kumaraswamy Distribution in Analyzing the Health-related Quality of Life and Effective Factors in Elderly Patients with Epilepsy
- 2019
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Ingår i: Archives of Neuroscience. - : Kowsar Publishing Corporation. - 2322-3944 .- 2322-5769. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epilepsy, which develops in the elderly, is recognized as a major health burden. Although health-related quality of life (HRQoL) is an essential element in the medical treatment of elderly patients with epilepsy, it is a question whether epilepsy and its treatment effectively influence the quality of life (QoL) in the elderly. Objectives: The current study aimed at evaluating the relationship between demographic and clinical aspects of epilepsy in HRQoL of elderly patients. Since HRQoL scores are bounded, the Kumaraswamy (Kum) regression model was used to analyze the data. Methods: The current study was conducted on 766 elderly patients diagnosed with epilepsy taking at least one antiepileptic drug (AED) selected from six neurologic clinics in Iran. In addition to demographic information, the Liverpool seizure severity scale (LSSS), medication adherence report scale (MARS-5), and quality of life in epilepsy (QoLIE-31) questionnaire were completed for patients. Data were analyzed using multiple linear regression (MLR) and the Kum regression models. Results: Most of the patients included in the study had focal (70.2%) epilepsy. Mean duration of disease was 17.71 +/- 4.56 years and the average number of seizures was 3.4 +/- 3.2 episodes per month. The Kum regression model indicated that seizure frequency (beta = 0.157, P < 0.0001) and LSSS score (beta = -0.003, P = 0.009) were significant and negative predictors of overall QoLEI-31 score; MARS-5 score was a positive predictor of overall QoLEI-31 score (beta = 0.014, P= 0.002). However, disease duration and serum AED level had no significant effects on overall QoLEI-31 score. Conclusions: The findings suggested that increased seizure frequencyand severity were associated with lower QoL and medication adherence was directly associated with HRQoL. The Kum regression could be a suitable alternative to the methods currently used in the analysis of HRQoL data.
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