Quality of life in adults with refractory epilepsy in Thailand: a multicenter upcountry nationwide study.

INTRODUCTION

Health related quality of life (HRQoL) has become a pivotal outcome parameter for epilepsy management. Few studies have described the variables that impact quality of life (QoL) in patients with refractory epilepsy in developing Asian countries. Here, we sought to assess the relationship of sociodemographic factors, epilepsy-related variables, and psychiatric comorbidity with HRQoL.

METHODS

We consecutively recruited a sample of adult patients with confirmed refractory epilepsy in multiple centers in Thailand. Multivariable linear regression analyses were used to identify socio-demographic factors, epilepsy-related variables, and psychiatric comorbidity factors associated with quality of life using QOLIE-31 score. Regression models were based on a pre-compiled directed acyclic graph (DAG).

RESULTS

A total of 394 patients from seven centers were evaluated. The mean QOLIE-31 score was 59.3 (SD = 15.5). The subscale score for overall quality of life was the highest (65.0 ± 15.9) and that for social function was the lowest (51.6 ± 25.2). There were significant differences between age groups, gender, current working status, seizure frequency, depression, anxiety, and QOLIE-31 score in the univariate analysis. Multivariable regression analyses identified significant total effects of age and gender on quality of life, significant direct effects of depression and anxiety, and both total and direct effects of seizure frequency, current working status, depression, and anxiety, indicating that the DAG sought factors associated with quality of life. We found a statistically significant difference in QOLIE-31 scores between age groups and religion-interaction, current working status, depression, and anxiety.

CONCLUSIONS

Our study included adult patients with focal refractory epilepsy. In addition to age and gender, depression, anxiety, and seizure frequency were the main determinants of QOL. Thus, improvement of QOL by screening for its factors should be one of the main goals in the treatment of refractory epilepsy.