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Is self-management effective for improving the quality of life in adult epileptics? A systematic review and meta-analysis of randomized controlled trials

Is self-management effective for improving the quality of life in adult epileptics? A systematic review and meta-analysis of randomized controlled trials
Is self-management effective for improving the quality of life in adult epileptics? A systematic review and meta-analysis of randomized controlled trials
Epilepsy is a chronic brain disorder with high morbidity and mortality. Self-management for epileptic patients is a complex and targeted process requiring taking medication, tracking seizures, ensuring medication adherence, managing negative events, adapting to the environment, keeping healthy lifestyle and maintaining good relationship with family and friends. An increasing number of studies have reported that self-management has become an important adjuvant for controlling epilepsy. However there have been no systematic reviews carried out to evaluate the effectiveness of self-management to improve the quality of life in adult epileptics.
Methods

Randomized controlled trials on self-management for adult epilepsy were included. Web of Science, PubMed, Science Direct, Cochrane Library, CNKI, VIP and Wanfang databases were searched. Reporting quality of trials was assessed by two reviewers independently using the Cochrane Risk of Bias Tool. The study was registered on PROSPERO registration number CRD42017078356.
Results

Eleven trials involving 1217 participants were identified. Meta-analysis showed that self-management interventions could improve quality of life (SMD 0.69, 95% CI [0.26, 1.11]; I2 = 90%), reduce depression (SMD −0.31, 95% CI [−0.60, −0.01]; I2 = 78%), increase self-efficacy (SMD 0.52, 95% CI [0.34, 0.69]; I2 = 44%) and self-management (MD 3.35, 95% CI [0.33, 6.37]; I2 = 87%), and improve medical adherence (MD 0.21, 95% CI [0.06, 0.36]; I2 = 0%) for adult epileptics, but had no effect on seizure frequency (MD −0.73, 95% CI [−5.63, 4.16]; I2 = 54%) and negative health events (MD −2.30, 95% CI [−8.31, 3.27]; I2 = 71%). Reporting and methodological quality was limited for all included trials.
Conclusion

Self-management may be effective in improving for quality of life in adult epileptics. However, these findings should be interpreted with caution due to the methodological quality of included trials. Furthermore, strict trials with precise methodological design and rigorous reporting on clinical efficacy and adverse events controlling self-management for epilepsy may be promising.
Self-management, Quality of life, Epilepsy, Self efficacy, Adherence, Meta-analysis
1876-3820
Wang, Zhijie
5d191904-f06c-4f12-b3b6-0e0053661a1e
Zhang, Yu
a851ce00-2181-4b85-bb62-50fcbee83a95
Xin, Yan
8f46b1a0-fee2-44bc-8040-bbca46ec2393
Guo, Wei
2addd16f-55f9-4dff-be7b-7232d6c22fd3
Zhuang, Lixing
d1de1b3b-c865-4cf0-b601-deb6ee14d771
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Gao, Xiao
27617d45-cae2-4cb8-ad31-774daa1a61d2
Wang, Zhijie
5d191904-f06c-4f12-b3b6-0e0053661a1e
Zhang, Yu
a851ce00-2181-4b85-bb62-50fcbee83a95
Xin, Yan
8f46b1a0-fee2-44bc-8040-bbca46ec2393
Guo, Wei
2addd16f-55f9-4dff-be7b-7232d6c22fd3
Zhuang, Lixing
d1de1b3b-c865-4cf0-b601-deb6ee14d771
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Gao, Xiao
27617d45-cae2-4cb8-ad31-774daa1a61d2

Wang, Zhijie, Zhang, Yu, Xin, Yan, Guo, Wei, Zhuang, Lixing, Hu, Xiaoyang and Gao, Xiao (2019) Is self-management effective for improving the quality of life in adult epileptics? A systematic review and meta-analysis of randomized controlled trials. European Journal of Integrative Medicine, 29, [100926]. (doi:10.1016/j.eujim.2019.100926).

Record type: Article

Abstract

Epilepsy is a chronic brain disorder with high morbidity and mortality. Self-management for epileptic patients is a complex and targeted process requiring taking medication, tracking seizures, ensuring medication adherence, managing negative events, adapting to the environment, keeping healthy lifestyle and maintaining good relationship with family and friends. An increasing number of studies have reported that self-management has become an important adjuvant for controlling epilepsy. However there have been no systematic reviews carried out to evaluate the effectiveness of self-management to improve the quality of life in adult epileptics.
Methods

Randomized controlled trials on self-management for adult epilepsy were included. Web of Science, PubMed, Science Direct, Cochrane Library, CNKI, VIP and Wanfang databases were searched. Reporting quality of trials was assessed by two reviewers independently using the Cochrane Risk of Bias Tool. The study was registered on PROSPERO registration number CRD42017078356.
Results

Eleven trials involving 1217 participants were identified. Meta-analysis showed that self-management interventions could improve quality of life (SMD 0.69, 95% CI [0.26, 1.11]; I2 = 90%), reduce depression (SMD −0.31, 95% CI [−0.60, −0.01]; I2 = 78%), increase self-efficacy (SMD 0.52, 95% CI [0.34, 0.69]; I2 = 44%) and self-management (MD 3.35, 95% CI [0.33, 6.37]; I2 = 87%), and improve medical adherence (MD 0.21, 95% CI [0.06, 0.36]; I2 = 0%) for adult epileptics, but had no effect on seizure frequency (MD −0.73, 95% CI [−5.63, 4.16]; I2 = 54%) and negative health events (MD −2.30, 95% CI [−8.31, 3.27]; I2 = 71%). Reporting and methodological quality was limited for all included trials.
Conclusion

Self-management may be effective in improving for quality of life in adult epileptics. However, these findings should be interpreted with caution due to the methodological quality of included trials. Furthermore, strict trials with precise methodological design and rigorous reporting on clinical efficacy and adverse events controlling self-management for epilepsy may be promising.

Full text not available from this repository.

More information

Accepted/In Press date: 6 June 2019
e-pub ahead of print date: 15 June 2019
Published date: August 2019
Keywords: Self-management, Quality of life, Epilepsy, Self efficacy, Adherence, Meta-analysis

Identifiers

Local EPrints ID: 434371
URI: http://eprints.soton.ac.uk/id/eprint/434371
ISSN: 1876-3820
PURE UUID: e2c3fd04-28cb-4eff-9bf0-49f9aadca761
ORCID for Xiaoyang Hu: ORCID iD orcid.org/0000-0002-3143-7999

Catalogue record

Date deposited: 20 Sep 2019 16:30
Last modified: 07 Oct 2020 02:09

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