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Service delivery, behavioural, and self-management interventions for adults with epilepsy
Yun Huang1,2, Sarah J Nevitt3,4, Josephine Mayer2,5
1Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
The Cochrane Database of Systematic Reviews
|September 24, 2025
Summary
Behavioral and self-management interventions show limited evidence for improving seizure control or quality of life in adults with epilepsy. Further research is needed to confirm long-term benefits and applicability across diverse patient populations.
Area of Science:
- Neurology
- Public Health
- Evidence-Based Medicine
Background:
- Epilepsy affects millions globally, with a significant portion experiencing uncontrolled seizures despite medication.
- Current treatments often overlook cognitive, psychological, and behavioral aspects crucial for improving seizure control and quality of life.
Purpose of the Study:
- To evaluate the effectiveness of service delivery, behavioral, and self-management interventions for adults with epilepsy.
- To assess impacts on seizure control and health-related quality of life (HRQoL).
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
- Inclusion of interventions targeting behavioral, self-management, or service delivery approaches.
- Primary outcome: seizure frequency; Secondary outcomes: seizure severity, HRQoL, medication usage, and others.
Main Results:
- Psycho-behavioral interventions may reduce seizure frequency in the short term (moderate-certainty evidence).
- Mind-body and self-management interventions show limited or uncertain effects on seizure frequency and HRQoL.
- Evidence for physical exercise and nurse-led service delivery interventions on seizure control and HRQoL is uncertain or negative.
Conclusions:
- No high-certainty evidence supports the use of these interventions for improving seizure control or HRQoL in adults with epilepsy.
- Heterogeneity in study design, interventions, and populations limits current evidence interpretation.
- Well-designed studies with validated measures are needed to assess long-term outcomes.
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