Epilepsy
Conditions
Keywords
Epilepsy Memory Problems, Self-Management
Brief summary
The purpose of this study is to determine the efficacy of an entirely virtual version of the home-based cognitive self-management program HOBSCOTCH. It will test whether HOBSCOTCH can be delivered nationally from a distance utilizing e-health tools (telephone, computer, and phone).
Detailed description
HOBSCOTCH (Home Based Self-management and Cognitive Training Changes lives) is a home-based self-management program to treat cognitive symptoms and improve quality of life, while minimizing the barriers of access to care. The program is based on Problem Solving Therapy (PST) and teaches problem solving strategies and compensatory mechanisms to help manage cognitive dysfunction and enhance quality of life. HOBSCOTCH Phase III is a study to examine an entirely virtual version of the program. While HOBSCOTCH was shown to be effective as an in-person and telephone-based program in previous trials (HOBSCOTCH Phase I and II), this study aims to test a version of the program adapted for entirely virtual delivery. This is a single-center study, with the HOBSCOTCH intervention being delivered by staff affiliated with Dartmouth-Hitchcock Medical Center in Lebanon, NH.
Interventions
HOBSCOTCH is a home-based self-management program to treat cognitive symptoms and improve quality of life, while minimizing the barriers of access to care. The program is based on Problem Solving Therapy (PST) and teaches problem solving strategies and compensatory mechanisms to help manage cognitive dysfunction and enhance quality of life.
Sponsors
Centers for Disease Control and Prevention
Dartmouth-Hitchcock Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18+ * Diagnosis of epilepsy, with controlled or uncontrolled seizures * Subjective memory complaints * No changes in antiepileptic and antidepressant medication regimen for 1 month, however brief discontinuation of antiepileptic medicine for inpatient video EEG evaluation is acceptable * Literate * Telephone access * Internet access
Exclusion criteria
* Subjects self-reporting a dementing illness or a mention of a dementing illness in their medical record * Severe mental disability or estimated IQ less than 70 per clinical judgement * Significant visual impairment precluding reading or writing * No reliable telephone or internet access * No diagnosis of epilepsy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in quality of life | Baseline and at months 3, 6, 9, 12 | The researchers will use the Quality of Life in Epilepsy (QOLIE-31). This validated tool contains 16 multi-item scales which assess health related quality of life, emotional well-being, memory and attention deficits, medication effects, seizure control, psychosocial functioning, and health perception. Scores range from 0 to 100, with a higher score reflecting a higher quality of life. |
| Change in cognitive function | Baseline and at months 3, 6, 9, 12 | The researchers will use the Cognitive Function sub-scale of the NeuroQOL. This is a brief validated tool developed by the NIH for use in patients with neurological disease. Scores range from 8 to 40, with a higher score indicating better reported cognitive functioning. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in self-reported seizure frequency | Ongoing through entire study baseline - 12 months | The researchers will collect seizure information throughout the entire study by use of a smartphone app or paper log to track seizures daily. No range. |
| Changes in medication adherence | Ongoing through entire study baseline - 12 months, and at baseline and at months 3, 6, 9, 12 | Medication adherence will be collected using the Medication Adherence Rating Scale (MARS), a 10-item inventory to measure medication adherence, as well as by a daily single item medication adherence question through a smartphone app or paper log. For the MARS, scores range from 0 to 10, with a higher score indicating better adherence. |
| Change in depression | Baseline and at months 3, 6, 9, 12 | The researchers will use the Patient Health Questionnaire (PHQ-9). The PHQ-9 is a brief 9-item validated depression scale. Scores range from 0 to 27. Scores of 5, 10, 15, and 20 represent cut-offs for mild, moderate, moderately severe, and severe depression, respectively. |
| Changes in healthcare utilization | Baseline and at months 3, 6, 9, 12 | The researchers will use the Health Care Utilization 4-item measure from the Self-Management Resource Center to capture utilization of health services in the last 6 months. No range. |
| Changes in overall well-being | Ongoing through entire study baseline - 12 months | The researchers will collect daily well-being information throughout the entire study by use of a smartphone app or paper log and a basic single item Likert-scale of well-being. No range. |
| Changes in health confidence | Baseline and at months 3, 6, 9, 12 | The researchers will use the Health Confidence Score, a 4-item measure of health confidence. Scores range from 0 to 13, with a higher score indicating better health confidence. |
| Change in self-management practices | Baseline and at months 3, 6, 9, 12 | The researchers will use the Adult Epilepsy Self-Management Measurement Instrument (AESMMI-65).This is a 65 item scale that assesses use of epilepsy self-management practices. Scores range from 65 to 325, with a higher score indicating more frequent use of self-management strategies. |
Countries
United States
Outcome results
None listed