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乌干达成年癫痫患者自我管理干预以减轻癫痫负担(SMART-U):随机临床试验方案

Self-Management Intervention for Reducing Epilepsy Burden Among Adult Ugandans with Epilepsy (SMART-U): Randomised Clinical Trial Protocol.

作者信息

Mbalinda Scovia Nalugo, Kaddumukasa Mark, Najjuma Josephine Nambi, Birungi Doreen R, Kaddumukasa Martin Ntambi, Levin Jennifer B, Still Carolyn Harmon, Burant Christopher J, Modi Avani C, Katabira Elly T, Sajatovic Martha

机构信息

Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda.

Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

出版信息

Neuropsychiatr Dis Treat. 2024 Nov 25;20:2277-2286. doi: 10.2147/NDT.S490050. eCollection 2024.

Abstract

BACKGROUND

People of all ages are affected by epilepsy, a prevalent chronic brain illness that is primarily found in underdeveloped nations. It is very necessary to implement epilepsy self-management techniques to support individuals with epilepsy in order to impact outcomes related to epilepsy. The purpose of this 2-site randomised controlled experiment is to investigate this further, based on encouraging preliminary evidence.

METHODS

A total of 188 adult people with epilepsy (PWE) attending the neurology clinics at Mulago and Mbarara hospitals and consent to participate in the study will be recruited. They will be randomised into intervention versus enhanced treatment control (eTAU) study groups. The intervention group will receive 12-week "intensive" educational sessions and a 12-week remotely accessed telephone follow-up stage. The controls will continue in their usual care supplemented by written materials on epilepsy in their preferred language and tailored to the reading level of most patients at the clinic. SMART-U consists of 2 main components: a 12-week "intensive" group format stage and a 12-week remotely accessed telephone follow-up stage. SMART-U will be assessed for acceptability, fidelity, and efficacy compared to eTAU. The primary study outcome is the mean change in cumulative past 24-week seizure frequency (24 weeks prior to the study baseline compared to the 24-week follow-up). Seizure frequency will be via self-report with corroboration by family/support system informants whenever possible. Participants will self-report the seizure frequency (numeric count) that they experienced between baseline and 13 weeks and again between 13 and 24 weeks, and the mean change from baseline to 24 weeks in QOL.

DISCUSSION

The curriculum-guided Self-Management intervention for Reducing The epilepsy burden among Ugandans (SMART-U) program is anticipated to reduce the epilepsy burden seizure frequency and improve other health outcomes, including depression, functional status and health resource use.

TRIAL REGISTRATION NUMBER TRN

NCT06139198.

DATE OF REGISTRATION

November142023.

摘要

背景

癫痫是一种常见的慢性脑部疾病,各个年龄段的人都可能受到影响,在欠发达国家尤为普遍。为了改善与癫痫相关的预后,实施癫痫自我管理技术对癫痫患者提供支持非常必要。基于令人鼓舞的初步证据,这项双中心随机对照试验旨在进一步对此进行研究。

方法

将招募188名在穆拉戈医院和姆巴拉拉医院神经科门诊就诊且同意参与研究的成年癫痫患者(PWE)。他们将被随机分为干预组和强化治疗对照组(eTAU)。干预组将接受为期12周的“强化”教育课程以及为期12周的远程电话随访阶段。对照组将继续接受常规护理,并辅以用其首选语言编写的、根据诊所大多数患者阅读水平量身定制的癫痫书面材料。SMART-U由两个主要部分组成:一个为期12周的“强化”小组形式阶段和一个为期12周的远程电话随访阶段。将与eTAU相比,评估SMART-U的可接受性、保真度和疗效。主要研究结局是过去24周累积癫痫发作频率的平均变化(研究基线前24周与24周随访相比)。癫痫发作频率将通过自我报告,并尽可能由家庭/支持系统 informant 进行佐证。参与者将自我报告他们在基线至13周以及13至24周之间经历的癫痫发作频率(数字计数),以及从基线到24周的生活质量平均变化。

讨论

预计以课程为导向的减轻乌干达人癫痫负担自我管理干预(SMART-U)计划将降低癫痫负担、癫痫发作频率,并改善其他健康结局,包括抑郁、功能状态和卫生资源利用。

试验注册号

TRN:NCT06139198。

注册日期

2023年11月14日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5deb/11606334/d73d3fdf8de8/NDT-20-2277-g0001.jpg

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