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Quality of life and its determinants in patients with drug resistant focal epilepsy

https://doi.org/10.17749/2077-8333/epi.par.con.2020.044

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Abstract

Objective: to determine the factors influencing quality of life (QoL) in patients with drug-resistant focal epilepsy (DRFE).
Material and methods. 111 adult patients with DRFE were included in the study. Quality of life was measured using the Quality Of Life In Patients with Epilepsy – 31 questionnaire (QOLIE-31). The severity of the disease (frequency and subjective assessment of the severity of seizures), the effect of pharmacotherapy (drug load and composition of the treatment regimen), the social status of patients, comorbid conditions (anxiety and depressive disorders, pathological fatigue) were assessed.
Results. In the studied sample, a pronounced decrease in QoL was shown, the median of the final QOLIE-31 score was 65.4 points (interquartile range 53.0–72.6 points). A statistically significant decrease in QoL was found in subgroups of patients with seizures during the previous three months; taking carbamazepine or benzobarbital; with anxiety and depressive disorders; with pathological fatigue; and in unemployed patients. A multiple linear regression model (R2=0.66) was developed, which included the following determinants: Fatigue Severity Scale, Liverpool Seizure Severity Scale, and the risk of depression according to the NDDI-E questionnaire.
Conclusion. In patients with drug-resistant focal epilepsy, there is a pronounced decrease in the quality of life due to combination of factors associated with the characteristics of the disease, treatment, comorbidities, and social status. The key QoL determinants in patients with DRFE are pathological fatigue, anxiety and depression, and subjective severity of epileptic seizures; employment is a positive factor. The role of epileptic seizures frequency in QoL formation in these patients requires further research.

About the Authors

S. М. Malyshev
Almazov National Medical Research Centre
Russian Federation

Stanislav M. Malyshev – Postgraduate Student, Department of Neurology and Psychiatry, Institute of Medical Education

ResearcherID: N-7251-2016; RSCI SPIN-code: 6306-0424

12 Mayakovskiy Str., Saint Petersburg 191014



Т. М. Alekseeva
Almazov National Medical Research Centre
Russian Federation

Tatiana M. Alekseeva – Dr. Med. Sc., Head of the Department of Neurology and Psychiatry, Institute of Medical Education

ResearcherID: S-8806-2017; RSCI SPIN-code: 3219-2846

12 Mayakovskiy Str., Saint Petersburg 191014



References

1. Mikhailov V.A. Topical issues of epileptology – stigmatization, quality of life and rehabilitation of patients. Epilepsy and Paroxysmal Conditions. 2010; 2 (3): 39–44 (in Russ.).

2. Kissin M.Ya., Neznanov N.G. Epidemiology of mental disorders in epileptic patients in St. Petersburg. Social'naya i klinicheskaya psikhiatriya / Social and Clinical Psychiatry. 2006; 16 (4): 5–9 (in Russ.).

3. Guzeva O.V., Guzeva V.I. Guzeva V.V., et al. Quality of life of children with epilepsy (neuropsychiatric and social aspects). The Scientific Notes of the Pavlov University. 2016; 23 (4): 12–7. https://doi.org/10.24884/1607-4181-2016-23-4-12-17 (in Russ.).

4. Steiger B.K., Jokeit H. Why epilepsy challenges social life. Seizure. 2017; 44: 194–8. https://doi.org/10.1016/j.seizure.2016.09.008.

5. Ebrahim S. Clinical and public health perspectives and applications of health-related quality of life measurement. Soc Sci Med. 1995; 41 (10): 1383–94. https://doi.org/10.1016/0277-9536(95)00116-o.

6. Shlyakhto E.V., Yakovenko I.V. Outcome-based healthcare. Translational Medicine. 2017; 4 (1): 6–10 (in Russ.).

7. Melikyan E., Guekht A., Milchakova L., et al. Health-related quality of life in Russian adults with epilepsy: the effect of socio-demographic and clinical factors. Epilepsy Behav. 2012; 25 (4): 670–5. http://dx.doi.org/10.1016/j.yebeh.2012.09.042.

8. Saadi A., Patenaude B., Mateen F.J. Quality of life in epilepsy – 31 inventory (QOLIE-31) scores: a global comparison. Epilepsy Behav. 2016; 65: 13–7. https://doi.org/10.1016/j.yebeh.2016.09.032.

9. Firsov K.V., Amirhanyan M.G., Kotov A.S. Patients with resistant focal epilepsy: what affects the quality of life? Epilepsy and Paroxysmal Conditions. 2019; 11 (3): 233–43 (in Russ.). http://dx.doi.org/10.17749/2077-8333.2019.11.3.233-243.

10. Blond B.N., Detyniecki K., Hirsch L.J. Assessment of treatment side effects and quality of life in people with epilepsy. Neurol Clin. 2016; 34 (2): 395–410. https://doi.org/10.1016/j.ncl.2015.11.002.

11. Baranowski C.J. The quality of life of older adults with epilepsy: a systematic review. Seizure. 2018; 60: 190–7. https://doi.org/10.1016/j.seizure.2018.06.002.

12. Silva B., Canas-Simião H., Cordeiro S., et al. Determinants of quality of life in patients with drug-resistant epilepsy. Epilepsy Behav. 2019; 100 (Pt A): 106525. https://doi.org/10.1016/j.yebeh.2019.106525.

13. Kwon O.Y., Ahn H.S., Kim H.J. Fatigue in epilepsy: a systematic review and meta-analysis. Seizure. 2017; 45: 151–9. https://doi.org/10.1016/j.seizure.2016.11.006.

14. Kwan P., Arzimanoglou A., Berg A.T., et al. Definition of drug-resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010; 51 (6): 1069–77. https://doi.org/10.1111/j.1528-1167.2009.02397.x.

15. Deckers C.L., Hekster Y.A., Keyser A., et al. Reappraisal of polytherapy in epilepsy: a critical review of drug load and adverse effects. Epilepsia. 1997; 38 (5): 570–5. https://doi.org/10.1111/j.1528-1157.1997.tb01142.x.

16. ATC/DDD Index 2020. WHO Collaborating Centre for Drug Statistics Methodology. Available at: https://www.whocc.no/atc_ddd_index (accessed December 25, 2020).

17. Gavrilov Y.V., Shkilnyuk G.G., Valko P.O., et al. Validation of the Russian version of the Fatigue Impact Scale and Fatigue Severity Scale in multiple sclerosis patients. Acta Neurol Scand. 2018; 138 (5): 408–16. https://doi.org/10.1111/ane.12993.

18. Alekseeva T.M., Gavrilov Y.V., Kreis O.A., et al. Fatigue in patients with myasthenia gravis. J Neurol. 2018; 265(10): 2312–2321. https://doi.org/10.1007/s00415-018-8995-4.

19. Alekseeva T.M., Kreis O.A., Gavrilov Y.V., et al. Impact of autoimmune comorbidity on fatigue, sleepiness and mood in myasthenia gravis. J Neurol. 2018; 265 (10): 2312–21. https://doi.org/10.1007/s00415-018-8995-4.

20. Lebedeva A.V., Melikyan E G., Stepanenko A.Y., et al. Quality of life dynamics in pharmacoresistant epilepsy patients after epilepsy surgery. Bulletin of Pirogov National Medical & Surgical Centre. 2011; 6 (3): 67–70 (in Russ.).

21. Melikyan E.G., Gekht A.B. Quality of life in elderly patients with epilepsy. Clinical Gerontology. 2011; 17 (7–8): 15–9 (in Russ.).

22. Hamid H., Blackmon K., Cong X., et al. Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery. Neurology. 2014; 82 (10): 887–94. https://doi.org/10.1212/wnl.0000000000000183.

23. Taylor R.S., Sander J.W., Taylor R.J., Baker G.A. Predictors of health-related quality of life and costs in adults with epilepsy: a systematic review. Epilepsia. 2011; 52 (12): 2168–80. https://doi.org/10.1111/j.1528-1167.2011.03213.x.

24. Tombini M., Assenza G., Quintiliani L., et al. Epilepsy-associated stigma from the perspective of people with epilepsy and the community in Italy. Epilepsy Behav. 2019; 98 (Pt A): 66–72. https://doi.org/10.1016/j.yebeh.2019.06.026.

25. Elsharkawy A.E., Thorbecke R., Ebner A., May T.W. Determinants of quality of life in patients with refractory focal epilepsy who were not eligible for surgery or who rejected surgery. Epilepsy Behav. 2012; 24 (2): 249–55. https://doi.org/10.1016/j.yebeh.2012.03.012.

26. Luoni C., Bisulli F., Canevini M.P., et al. Determinants of health-related quality of life in pharmacoresistant epilepsy: results from a large multicenter study of consecutively enrolled patients using validated quantitative assessments. Epilepsia. 2011; 52 (12): 2181–91. https://doi.org/10.1111/j.1528-1167.2011.03325.x.

27. Ridsdale L., Wojewodka G., Robinson E., et al. Characteristics associated with quality of life among people with drug-resistant epilepsy. J Neurol. 2017; 264 (6): 1174–84. https://doi.org/10.1007/s00415-017-8512-1.

28. Aghaei-Lasboo A., Fisher R.S. Methods for measuring seizure frequency and severity. Neurol Clin. 2016; 34 (2): 383–94. https://doi.org/10.1016/j.ncl.2015.11.001.

29. Kuzminova M.V. Labor as a factor of resocialization of patients with epilepsy. Current Therapy of Mental Disorders. 2009: 2: 19–20 (in Russ.).

30. Fadin N.I. Employment rehabilitation of disabled persons in the concept of health-related quality of life. Living Standards of the Population in the Regions of Russia. 2016; 108 (4): 78–84 (in Russ.).

31. Fiest K.M., Dykeman J., Patten S.B., et al. Depression in epilepsy: a systematic review and meta-analysis. Neurology. 2013; 80 (6): 590–9. https://doi.org/10.1212/wnl.0b013e31827b1ae0.


For citation:


Malyshev S.М., Alekseeva Т.М. Quality of life and its determinants in patients with drug resistant focal epilepsy. Epilepsy and paroxysmal conditions. 2020;12(4):216-225. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2020.044

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)