Literature Review

Self-Management Intervention for Epilepsy Improves Health

The intervention appears to ameliorate mood and quality of life in people with a history of negative health events.


Self-management of epilepsy using a group-format, remote intervention improves mood, quality of life, and health functioning in high-risk individuals, according to a randomized, controlled trial published in the September issue of Epilepsia.

In the six-month trial, 120 individuals with epilepsy who had experienced at least one epilepsy-related negative health event in the previous six months were randomized to a wait-list control group or a novel self‐management intervention.

The eight-session intervention, known as SMART, focused on modifiable factors that can be addressed with self-management, such as stress, substance abuse, routine, nutrition, and social support. It was delivered remotely during eight to 10 weeks, either by telephone or online, after an initial in-person session.

“SMART combines the portability and low cost of a Web‐based intervention with the personally salient components of behavior modeling obtained by interacting with individuals who have walked the walk in living with epilepsy,” said Martha Sajatovic, MD, Professor of Psychiatry at Case Western Reserve University in Cleveland, and her colleagues.

Martha Sajatovic, MD

During the six-month follow-up period, individuals randomized to the intervention had a mean of 10.16 fewer negative health events, compared with a mean of 1.93 fewer events in the control group.

When the authors examined subcategories of negative health event counts (eg, past three-day seizure count or past six‐month emergency department and hospitalization count), the differences between groups were not significant. There was also no difference between groups in seizure severity.

The study showed significant improvements in participants’ self-rated depressive symptom severity, observer-rated depressive symptom severity, quality of life, and physical and mental health functioning, compared with controls. The intervention group also reported significant improvements on the Epilepsy Self-Efficacy and Epilepsy Self-Management scales.

Most participants (94.2%) said that the intervention was useful and addressed their most important issues. Approximately 92% said that the benefits of the SMART intervention were worth the effort.

“It is possible that SMART, which uses people with epilepsy as guides to help others learn to cope with the challenges of living with this common chronic neurologic condition, may help to alleviate some of the factors that prevent people with epilepsy from optimizing their quality of life.”

—Bianca Nogrady

Suggested Reading

Sajatovic M, Colon-Zimmermann K, Kahriman M, et al. A 6-month prospective randomized controlled trial of remotely delivered group format epilepsy self-management versus waitlist control for high-risk people with epilepsy. Epilepsia. 2018;59(9):1684-1695.

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