Multidisciplinary management improves anxiety, depression, medication adherence, and quality of life among patients with epilepsy in eastern China: A prospective study

Epilepsy Behav. 2019 Nov;100(Pt A):106400. doi: 10.1016/j.yebeh.2019.07.001. Epub 2019 Oct 18.

Abstract

Objective: The objective of this study was to investigate the effect of a multidisciplinary program on anxiety, depression, medication adherence, and quality of life in patients with epilepsy in eastern China.

Methods: A cohort of 184 patients with epilepsy from the epilepsy clinic of a tertiary hospital in eastern China completed this program, out of which 92 were randomized into the intervention group and 92 the control group. Patients in both groups received standard antiepileptic drugs (AEDs), while those of the intervention group received an additional 12-month multidisciplinary program developed by a group of the epileptologist, pharmacist, psychiatrist, and epilepsy specialist nurse. Patients were assessed both before and after the 12-month period. The Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the eight-item Morisky Medication Adherence Scale (MMAS-8) were used to assess the severity of depression, anxiety, and medication adherence, respectively, along with Quality of life in Epilepsy-31 (QOLIE-31) and self-reported seizure frequency for life quality and seizure severity.

Results: The 12-month multidisciplinary program significantly reduced the number of patients with severe depression (p = 0.013) and anxiety (p = 0.002), increased the number of patients with moderate-to-high AED adherence (p = 0.006) and the overall QOLIE-31 score (p < 0.001) in the intervention group. Both groups demonstrated a significant increase in the number of patients with a low seizure frequency after the 12-month period (p < 0.001).

Conclusion: The 12-month multidisciplinary program offers an effective management strategy in improving psychiatric comorbidities, medication adherence, and quality of life in patients with epilepsy in eastern China.

Keywords: Anxiety; Depression; Epilepsy; Medication adherence; Multidisciplinary; Quality of life.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / therapeutic use*
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Anxiety / prevention & control*
  • China
  • Combined Modality Therapy
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / etiology
  • Depression / prevention & control*
  • Epilepsy / complications
  • Epilepsy / psychology
  • Epilepsy / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Interdisciplinary Communication
  • Male
  • Medication Adherence / psychology*
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Patient Care Team
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology*
  • Self Report
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants