Health-related quality of life in epilepsy patients receiving anti-epileptic drugs at National Referral Hospitals in Uganda: a cross-sectional study

Abstract

BackgroundEpilepsy is a devastating disorder that impacts on patients’ quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs.MethodsA total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL.ResultsJust about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0–100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL.ConclusionThe HRQOL for epilepsy patients on AEDs is very low. The predictors of low HRQOL were socio factors (marital status, education) and drug side effects, frequency of seizure, and type of therapy.

Predictors of health related quality of life in childhood epilepsy and comparison with healthy children: findings from an Indian study

“…This could be due to small study bias as the included sample was much smaller (n = 40) (31). Moreover, polytherapy is associated with complex dosing regimens that might be cumbersome for children as well as parents to comply with regularly (37). The present study also found significantly higher scores in the psychosocial domain in children prescribed monotherapy as compared to polytherapy.…”

Assessment of quality of life in patients on antiepileptic drugs: a hospital based cross sectional study

“…Quality of life (QOL) is worse in epileptic patients than in the general population, it is comparable or worse in patients with epilepsy than that in patients with other chronic conditions; and it is similar to that of healthy persons when patients with epilepsy are well-controlled. 8 QOL of patients with epilepsy depends upon effectiveness of antiepileptic therapy and disease duration. Frequency of seizures seems to be one of the most relevant determinants of poor quality-of-life scores.…”

A Prospective Study on Impact of Patient Counselling on Quality of Life and Medication Adherence in Epileptic Patients

“…Camacho et al (2014) reported that majority of patients had focal seizures (52.2%) [14]. Contradictory results were found in Nabukenya et al says that majority of the respondents were having generalized epilepsy (84%) [15]. Control of seizure frequency is the main objective in the management of epilepsy.…”

“…Low T-scores are obtained for the subscales QOL (37.03±4.56), social function (43.74±1.80) and emotional wellbeing (45.56±4.43). Nabukenya et al reported that physical functioning and emotional well-being are the mostly affected HRQOL domains in people with epilepsy [15]. Martin et al described that seizure worry, medication effects, energy, or fatigue showed the greatest impact on QOL [17].…”