Addressing implementation challenges in the delivery of an epilepsy self-management program in community settings

Area of Science:

• Neurology
• Public Health
• Social Work

Background:

• Epilepsy self-management (ESM) programs are crucial for improving patient outcomes.
• Implementation of ESM in community settings presents unique challenges and opportunities.
• Social services agencies play a vital role in supporting individuals with chronic health conditions.

Purpose of the Study:

• To describe the implementation of the SMART epilepsy self-management (ESM) program within community-based social services agencies.
• To evaluate the effectiveness of the SMART ESM program on seizure frequency, mental health, and quality of life in individuals with epilepsy.

Main Methods:

• The SMART ESM program was delivered by three epilepsy-focused social services agencies.
• Pre- and post-intervention outcomes were assessed using measures for seizure frequency, Patient Health Questionnaire (PHQ-9), Quality of Life in Epilepsy (QOLIE-10), and Generalized Anxiety Disorder (GAD-7) scale.
• Trained nurses and peer educators delivered the program, with participants attending a mean of 5.7 out of 8 sessions.

Main Results:

• Significant improvements were observed in PHQ-9 scores (p=0.026) and QOLIE-10 scores (p<0.007), indicating better mental health and quality of life.
• No significant changes were found in GAD-7 scores or past 30-day seizure frequency.
• A substantial proportion of participants reported social determinants of health distress, including housing insecurity (30.3%), food insecurity (44.9%), and financial strain (74.2%).

Conclusions:

• Epilepsy-focused social services agencies can effectively implement ESM programs.
• The SMART ESM program demonstrates potential for improving mental health and quality of life for individuals with epilepsy.
• Agency experience in implementing ESM can guide other social services agencies in supporting clients with epilepsy.