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Abstract

Background: Epilepsy is a chronic neurological disease that has a significant influence on individuals' daily activities and health-related quality of life (HRQoL). The HRQoL among people with epilepsy varies depending on several factors. This study aimed to investigate the HRQoL of people with epilepsy and its predicting factors.

Methods: A convenience sampling method was applied to enroll 157 participants with epilepsy who were treated with medication at a tertiary hospital in Bangkok, Thailand, from August 2023 to January 2024. The questionnaires included general characteristics, comorbidities, generalized anxiety disorder (GAD), the International Physical Activity Questionnaire (IPAQ) short form, the Pittsburgh Sleep Quality Index (PSQI), the Medical Outcomes Study Social Support Survey (MOS-SSS) and quality of life in epilepsy inventory-31(QOLIE-31). Descriptive statistics and multiple regression analysis were used to analyze data.

Results: The average age of participants was 39.9 years (SD = 10.7), with 51% being male. 31.8% of them still experienced a seizure within the last month. The mean total HRQoL score was 74.6 (SD = 13.9). Comorbidities (B= -17.50), anxiety (B= -1.58), seizure frequency in the last month (B= -0.67), and social support score (B= 0.10) were significant predictors of total HRQoL among adults with epilepsy (p-values < 0.05), accounting for 50.3% of the explained variation.

Conclusions: Healthcare providers should regularly assess HRQoL and its significant factors among people with epilepsy. Proper management and comprehensive care should be provided to improve the quality of life of people with epilepsy.

Keywords: Health-related quality of life, Epilepsy, Seizures, Anxiety, Social support

References

[1] Beghi E. The epidemiology of epilepsy. Neuroepidemiology 2020;54(2):185e91. https://doi.org/10.1159/000503831.

[2] Fiest KM, Sauro KM, Wiebe S, Patten SB, Kwon C-S, Dykeman J, et al. Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies. Neurology 2017;88(3):296e303. https://doi.org/10.1212/WNL.0000000000003509.

[3] Idris A, Alabdaljabar MS, Almiro A, Alsuraimi A, Dawalibi A, Abduljawad S, et al. Prevalence, incidence, and risk factors of epilepsy in Arab countries: a systematic review. Seizure 2021; 92:40e50. https://doi.org/10.1016/j.seizure.2021.07.031.

[4] Adamu A, Chen R, Li A, Xue G. Epilepsy in Asian countries. Acta Epileptologica 2023;5(1):25. https://doi.org/10.1186/s42494-023-00136-1.

[5] Ioannou P, Foster DL, Sander JW, Dupont S, Gil-Nagel A, Drogon O, Flaherty E, et al. The burden of epilepsy and unmet need in people with focal seizures. Brain Behav 2022; 12(9):e2589. https://doi.org/10.1002/brb3.2589.

[6] Asawavichienjinda T, Sitthi-Amorn C, Tanyanont W. Prevalence of epilepsy in rural Thailand: a population-based study. J Med Assoc Thai 2002 Oct;85(10):1066e73.

[7] Falco-Walter J. Epilepsy definition, classification, pathophysiology, and epidemiology. Semin Neurol 2020 Dec;40(6): 617e23. https://doi.org/10.1055/s-0040-1718719.

[8] Bifftu BB, Tadesse Tiruneh B, Mekonnen Kelkay M, Bayu NH, Tewolde AW, Takele WW, et al. Seizure-related injuries among people with epilepsy at the outpatient department of the University of Gondar hospital, Northwest Ethiopia: cross-sectional institutional-based study. Neurol Res Int 2017;2017:4970691. https://doi.org/10.1155/2017/4970691.

[9] Tolchin B, Hirsch LJ, LaFrance Jr WC. Neuropsychiatric aspects of epilepsy. Psychiatr Clin North Am 2020;43(2): 275e90. https://doi.org/10.1016/j.psc.2020.02.002.

[10] Mahler B, Carlsson S, Andersson T, Tomson T. Risk for injuries and accidents in epilepsy. Neurology 2018;90(9): e779e89. https://doi.org/10.1212/WNL.0000000000005035.

[11] Krishnan V. Depression and anxiety in the epilepsies: from bench to bedside. Curr Neurol Neurosci Rep 2020;20(9):41. https://doi.org/10.1007/s11910-020-01065-z.

[12] Yogarajah M, Mula M. Social cognition, psychiatric comorbidities, and quality of life in adults with epilepsy. Epilepsy Behav 2019 Nov;100(Pt B):106321. https://doi.org/10.1016/j.yebeh.2019.05.017.

[13] Ayalew MB, Muche EA. Patient reported adverse events among epileptic patients taking antiepileptic drugs. SAGE Open Med 2018;6:2050312118772471. https://doi.org/10.1177/2050312118772471.

[14] Siebenbrodt K, Willems LM, von Podewils F, Mross PM, Strüber M, Langenbruch L, et al. Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany. Neurol Res Pract 2023;5(1):41. https://doi.org/10.1186/s42466-023-00265-5.

[15] Costa DSJ, Mercieca-Bebber R, Rutherford C, Tait MA, King MT. How is quality of life defined and assessed in published research? Qual Life Res 2021 Aug;30(8):2109e21. https://doi.org/10.1007/s11136-021-02826-0.

[16] Yesuf W, Hiko D, Alemayehu E, Kusheta S, Shita A, Beyene M. Health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy attending Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study. BMJ Open 2024;14(1): e079165. https://doi.org/10.1136/bmjopen-2023-079165.

[17] Tayeb HO, Alsawwaf Y, Khoja AA, Batarfi B, Baduwailan A, Yousef M, et al. Determinants of health-related quality of life of epilepsy patients in Jeddah, Saudi Arabia. Cureus 2022; 14(4):e24118. https://doi.org/10.7759/cureus.24118.

[18] Tefera GM, Megersa WA, Gadisa DA. Health-related quality of life and its determinants among ambulatory patients with epilepsy at Ambo General Hospital, Ethiopia: using WHOQOL-BREF. PLoS One 2020;15(1):e0227858. https://doi.org/10.1371/journal.pone.0227858.

[19] Phabphal K, Geater A, Limapichart K, Satirapunya P, Setthawatcharawanich S. Quality of life in epileptic patients in southern Thailand. J Med Assoc Thai 2009;92(6): 762e8.

[20] Phumart P, Limwattananon C, Kitwitee P, Unnwongse K, Tiamkao S. EQ-5D-based utilities and healthcare utilization in Thai adults with chronic epilepsy. Epilepsy Behav 2018 Jun;83:140e6. https://doi.org/10.1016/j.yebeh.2018.03.039.

[21] Tork MA, Rashed HR, Elnabil L, Salah-Eldin N, Elkhayat N, Abdelhady AA, et al. Sleep pattern in epilepsy patients: a polysomnographic study. Egypt J Neurol Psychiatry Neurosurg 2020;56(1):5. https://doi.org/10.1186/s41983-019-0141-4.

[22] Cano-Lopez I, Hampel KG, Garces M, Villanueva V, Gonzalez-Bono E. Quality of life in drug-resistant epilepsy: relationships with negative affectivity, memory, somatic symptoms and social support. J Psychosom Res 2018;114: 31e7. https://doi.org/10.1016/j.jpsychores.2018.09.001.

[23] Alkoblan FI, Alsoadan MM, Alhajri AA, Almousa MM, Alsalamah FS, Kazi A, et al. Social anxiety, social support, and quality of life in patients with epilepsy at a tertiary care hospital in Saudi Arabia. Cureus 2023;15(9):e45447. https://doi.org/10.7759/cureus.45447.

[24] Yongprawat T, Jarrat L, Seeboonruang A, Chansakul C, Danchaivijitr C. Study in the clinical outcomes and quality of life in epilepsy patients at Bangkok hospital headquarters. Bangk Med J 2020;16(2):144e52. https://doi.org/10.31524/bkkmedj.2020.21.006.

[25] Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009;41(4):1149e60. https://doi.org/10.3758/BRM.41.4.1149.

[26] Kost RG, de Rosa JC. Impact of survey length and compensation on validity, reliability, and sample characteristics for ultrashort-, short-, and long-research participant perception surveys. J Clin Transl Sci 2018;2(1):31e7. https://doi.org/10.1017/cts.2018.18.

[27] Horne R, Weinman J. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999;47(6):555e67. https://doi.org/10.1016/s0022-3999(99)00057-4.

[28] Lemay J, Waheedi M, Al-Sharqawi S, Bayoud T. Medication adherence in chronic illness: do beliefs about medications play a role? Patient Prefer Adherence 2018;12(null):1687e98. https://doi.org/10.2147/PPA.S169236.

[29] Spitzer RL, Kroenke K, Williams JB, L€ owe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006;166(10):1092e7. https://doi.org/10.1001/archinte.166.10.1092.

[30] Craig CL, Marshall AL, Sj€ ostr€ om M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35(8):1381e95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.

[31] Pothirat C, Chaiwong W, Liwsrisakun C, Phetsuk N, Theerakittikul T, Choomuang W, et al. Reliability of the Thai version of the international physical activity questionnaire short form in chronic obstructive pulmonary disease. J Bodyw Mov Ther 2021;27:55e9. https://doi.org/10.1016/j.jbmt.2021.01.007.

[32] Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Activ Health 2009;6(6):790e804. https://doi.org/10.1123/jpah.6.6.790.

[33] Buysse DJ, Reynolds IIICF, Monk TH, BermanSR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2): 193e213. https://doi.org/10.1016/0165-1781(89)90047-4.

[34] Sitasuwan T, Bussaratid S, Ruttanaumpawan P, Chotinaiwattarakul W. Reliability and validity of the Thai version of the Pittsburgh sleep quality Index. J Med Assoc Thai 2014;97(Suppl 3):S57e67.

[35] Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med 1991;32(6):705e14. https://doi.org/10.1016/0277-9536(91)90150-b.

[36] Rungruangsiripan M, Sitthimongkol Y, Maneesriwongul W, Talley S, Vorapongsathorn T. Mediating role of illness representation among social support, therapeutic alliance, experience of medication side effects, and medication adherence in persons with schizophrenia. Arch Psychiatr Nurs 2011;25(4):269e83. https://doi.org/10.1016/j.apnu.2010.09.002.

[37] Cramer JA, Perrine K, Devinsky O, Bryant-Comstock L, Meador K, Hermann B. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia 1998;39(1):81e8. https://doi.org/10.1111/j.1528-1157.1998.tb01278.x.

[38] Kanjanasilp J, Khaewwichit S, Richards RME, Preechagoon Y. Thai version of the quality-of-life in epilepsy inventory: comparison between the QOLIE-31 and the QOLIE-10. CMU J 2004;3(1):35.

[39] Romero M, Vivas-Consuelo D, Alvis-Guzman N. Is health related quality of life (HRQoL) a valid indicator for health systems evaluation? SpringerPlus 2013;2(1):664. https:// doi.org/10.1186/2193-1801-2-664.

[40] Babaei K, Khatiban M, Khazaei M, Tapak L, Shamsaei F. Self-Management and its Predictors in adult patients with epilepsy: a cross-sectional study. Ethiop J Health Sci 2023; 33(3):507e14. https://doi.org/10.4314/ejhs.v33i3.14.

[41] Sakthong P. Pharmacotherapy related quality of life in Thai patients with chronic diseases. Int J Clin Pharm 2019;41(4): 1004e11. https://doi.org/10.1007/s11096-019-00857-9.

[42] Butsing N, Tipayamongkholgul M, Ratanakorn D, Suwannapong N, Bundhamcharoen K. Social support, functional outcome and quality of life among stroke survivors in an urban area. J Pac Rim Psychol 2019;13:e4. https://doi.org/10.1017/prp.2019.2.

[43] Johannessen SI, Landmark CJ. Antiepileptic drug interactions- principles and clinical implications. Curr Neuropharmacol 2010;8(3):254e67. https://doi.org/10.2174/157015910792246254.

[44] Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K. Seizure cluster: definition, prevalence, consequences, and management. Seizure 2019;68:9e15. https://doi.org/10.1016/j.seizure.2018.05.013.

[45] Hingray C, McGonigal A, Kotwas I, Micoulaud-Franchi JA. The relationship between epilepsy and anxiety disorders. Curr Psychiatry Rep 2019;21(6):40. https://doi.org/10.1007/s11920-019-1029-9.

[46] Fazekas B, Megaw B, Eade D, Kronfeld N. Insights into the real-life experiences of people living with epilepsy: a qualitative netnographic study. Epilepsy Behav 2021;116:107729. https://doi.org/10.1016/j.yebeh.2020.107729.

[47] Strzelczyk A, Aledo-Serrano A, Coppola A, Didelot A, Bates E, Sainz-Fuertes R, et al. The impact of epilepsy on quality of life: findings from a European survey. Epilepsy Behav j.yebeh.2023.109179. https://doi.org/10.1016/

[48] Zhong R, Zhang H, Han Y, Guo X, Lin W. Social support for and features of Chinese adults with epilepsy. Acta Epileptol 2022;4(1):18. https://doi.org/10.1186/s42494-022-00087-z.

[49] Li C, Bi Q, Hu B, Sun L. Effect of self-management interventions for adults with epilepsy: a systematic review and meta-analysis. Ann Palliat Med 2021;10(12):12086e94. https://doi.org/10.21037/apm-21-2404.

[50] Rabiei DL, Lotfizadeh DM, Karimi Z, Masoudi DR. The effects of self-management education and support on self-eff icacy, self-esteem, and quality of life among patients with epilepsy. Seizure 2022;102:96e104. https://doi.org/10.1016/j.seizure.2022.09.023.

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