Abstract
BackgroundEpilepsy is a devastating disorder that impacts on patients’ quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs.MethodsA total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL.ResultsJust about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0–100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL.ConclusionThe HRQOL for epilepsy patients on AEDs is very low. The predictors of low HRQOL were socio factors (marital status, education) and drug side effects, frequency of seizure, and type of therapy.
Highlights
The prevalence of epilepsy, a chronic disorder characterized by recurring seizures [1,2,3], is estimated to be 3% in Uganda [4]
Of the 175 respondents, 54% were male; only 20% were employed and mainly in the informal sector; 62% had been on Anti epileptic drugs (AED) for at least 12 months; 50% were aged below 25 years; 51% had attained primary school education level at most; and majority of the patients (77%) were never married
In this study, we estimated the health-related quality of life (HRQOL) score for People with Epilepsy (PWE) in Uganda who had been on AEDs for at least three months and assessed the relative importance of the different HRQOL sub-scores and associated predictors
Summary
The prevalence of epilepsy, a chronic disorder characterized by recurring seizures [1,2,3], is estimated to be 3% in Uganda [4]. The AEDs’ side effects, especially for poly-therapies, have been shown to be negatively associated with health-related quality of life (HRQOL), independent of seizure frequency [8]. Other factors such as stigma [9], depression, anxiety and stress [10] and mood disorders [11] have been found to influence the quality of life of the patients with epilepsy more than seizure severity and frequency control. This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs
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