Efficacy of the epilepsy nurse: Results of a randomized controlled study

Pfäfflin, Margarete; Schmitz, Bettina; May, Theodor W.

doi:10.1111/epi.13424

Cited by 57 publications

(62 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,5,7 The challenge ahead of us is to integrate these different therapies in busy clinical practice. 12,13 Different models of practice can be trialed and adopted for the efficient management of the neuromodulation clinic. Having a specialized neuromodulation clinic allows efficient management of resources like scheduling field engineers to attend the clinic and to avoid multiple visits within a week.…”

Section: Discussionmentioning

confidence: 99%

Practice trends and the outcome of neuromodulation therapies in epilepsy: A single‐center study

et al. 2019

View full text Add to dashboard Cite

Neuromodulation therapies (VNS, RNS, and DBS) can improve seizure control in persons with epilepsy. However, there is a significant service gap in integrating these therapies in clinical care. Our epilepsy center has established an epilepsy neuromodulation clinic to improve access to patients, communication with referring physicians, track outcome and train future providers in programming neuromodulation devices. We report the (a) treatment outcome of the available neuromodulation therapies (ie, reduction in seizure frequency over 6‐12 months follow‐up); and (b) demonstrate the benefit of the specialized clinic (rapid titration, continuity of care, superior access for patient and vendors). In this single‐center, retrospective study, forty‐three adults (VNS = 27; RNS = 16) with drug‐resistant epilepsy were followed in the clinic during the 19 months study period. About 44‐69% of patients reported > 60% decrease in seizure. All patients were scheduled in the clinic within 2‐4 weeks, and stimulations were optimized rapidly. About 40% of patients participated in research while 28% were referred for additional diagnostic studies. Nineteen students and fellows were trained in programming neurostimulator. Epilepsy neuromodulation clinic can serve as an optimal solution for patients as well as providers due to rapid access, better continuity of care, higher recruitment for research studies, and training health professionals.

show abstract

Section: Discussionmentioning

confidence: 99%

Practice trends and the outcome of neuromodulation therapies in epilepsy: A single‐center study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…One hypothesis was that other measures, such as self-mastery, medication adherence and seizure frequency, could improve with increased knowledge. In the UK and other European countries, epilepsy nurses are taking an increasing role reinforcing advice about self-management [43–45] which could reduce the impact of memory issues. Self-management education, which is reinforced over time by a co-intervention of advice from a nurse or other professional, seems more likely to promote QoL [16, 43, 46].…”

Section: Discussionmentioning

confidence: 99%

Characteristics associated with quality of life among people with drug-resistant epilepsy

Ridsdale¹,

Wojewodka²,

Robinson

et al. 2017

J Neurol

View full text Add to dashboard Cite

Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants, what clinical and psycho-social characteristics are associated with QoL. We recruited 404 adults attending specialist clinics, with at least two seizures in the prior year and measured their self-reported seizure frequency, co-morbidity, psychological distress, social characteristics, including self-mastery and stigma, and epilepsy-specific QoL (QOLIE-31-P). Mean age was 42 years, 54% were female, and 75% white. Median time since diagnosis was 18 years, and 69% experienced ≥10 seizures in the prior year. Nearly half (46%) reported additional medical or psychiatric conditions, 54% reported current anxiety and 28% reported current depression symptoms at borderline or case level, with 63% reporting felt stigma. While a maximum QOLIE-31-P score is 100, participants’ mean score was 66, with a wide range (25–99). In order of large to small magnitude: depression, low self-mastery, anxiety, felt stigma, a history of medical and psychiatric comorbidity, low self-reported medication adherence, and greater seizure frequency were associated with low QOLIE-31-P scores. Despite specialist care, UK people with epilepsy and persistent seizures experience low QoL. If QoL is the main outcome in epilepsy trials, developing and evaluating ways to reduce psychological and social disadvantage are likely to be of primary importance. Educational courses may not change QoL, but be one component supporting self-management for people with long-term conditions, like epilepsy.

show abstract

“…Of the 15 RCTs investigating educational interventions, 4 studies were LOE II, 4 studies were LOE III, and 7 studies were LOE IV. All 4 LOE II studies reported improvements in their various primary outcomes: medication adherence, epilepsy knowledge and satisfaction with information and support, medication‐related problems, and HRQOL .…”

Section: Available Evidence For Psychological Treatment Across the Epmentioning

confidence: 99%

“…Only 1 RCT investigated a psychological intervention specifically aiming to decrease anxiety symptoms . Four studies investigating psychological interventions, 1 study investigating a self‐management program, and 1 study investigating an educational program measured anxiety symptoms as a secondary outcome. Three studies were LOE II, and 1 study was LOE III, whereas the remaining 3 studies were LOE IV .…”

Section: Available Evidence For Psychological Treatment Across the Epmentioning

confidence: 99%

“…Four studies investigating psychological interventions, 1 study investigating a self‐management program, and 1 study investigating an educational program measured anxiety symptoms as a secondary outcome. Three studies were LOE II, and 1 study was LOE III, whereas the remaining 3 studies were LOE IV . Of all LOE II studies, only the psychological intervention that measured anxiety symptoms as a secondary outcome reported a significant decrease in anxiety symptoms .…”

Section: Available Evidence For Psychological Treatment Across the Epmentioning

confidence: 99%

See 1 more Smart Citation

Psychological treatments for adults and children with epilepsy: Evidence‐based recommendations by the International League Against Epilepsy Psychology Task Force

et al. 2018

View full text Add to dashboard Cite

Given the significant impact that psychosocial factors and epilepsy treatments can have on the health-related quality of life (HRQOL) of individuals with epilepsy and their families, there is great clinical interest in the role of psychological evaluation and treatments to improve HRQOL and comorbidities. Therefore, the International League Against Epilepsy (ILAE) charged the Psychology Task Force with the development of recommendations for clinical care based on evaluation of the evidence from their recent Cochrane review of psychological treatments in individuals with epilepsy. The literature search for a recent Cochrane review of randomized controlled trials investigating psychological treatments for individuals with epilepsy constitutes the key source of evidence for this article. To provide practical guidance to service providers, we provide ratings on study research designs based on (1) the American Academy of Neurology's Level of Evidence system and (2) the Grading of Recommendations, Assessment, Development, and Evaluation system. This paper is the culmination of an international collaboration process involving pediatric and adult psychologists, neurologists, psychiatrists, and neuropsychiatrists. The process and conclusions were reviewed and approved by the ILAE Executive Committee. The strongest evidence for psychological interventions was identified for the most common mental health problems, including depression, neurocognitive disturbances, and medication adherence. Psychological interventions targeting the enhancement of HRQOL and adherence and a decrease in comorbidity symptoms (anxiety, depression) should be incorporated into comprehensive epilepsy care. There is a range of psychological strategies (ie, cognitive behavioral therapy and mindfulness-based therapies) that show promise for improving the lives of persons with epilepsy, and clinical recommendations are provided to assist epilepsy health care providers in treating the comorbidities and challenges associated with epilepsy and its treatments.

show abstract

Efficacy of the epilepsy nurse: Results of a randomized controlled study

Cited by 57 publications

References 35 publications

Practice trends and the outcome of neuromodulation therapies in epilepsy: A single‐center study

Practice trends and the outcome of neuromodulation therapies in epilepsy: A single‐center study

Characteristics associated with quality of life among people with drug-resistant epilepsy

Psychological treatments for adults and children with epilepsy: Evidence‐based recommendations by the International League Against Epilepsy Psychology Task Force

Contact Info

Product

Resources

About