Replication of an evidence-based epilepsy self-management program in Georgia (USA): The HOBSCOTCH trial.

BACKGROUND

The efficacy of Managing Epilepsy Well Network (MEWN) self-management programs is well-established. The purpose of this study was to replicate the HOBSCOTCH program to evaluate program implementation and assess effectiveness on patient cognition, quality of life and self-management behaviors.

METHODS

Participants from clinical and community settings were recruited and randomized to intervention vs waitlist control. Program outcomes assessing quality of life, cognition, treatment adherence, depressive symptoms, and self-management behavior were measured at baseline and 3 months. Program staff provided survey data guided by the RE-AIM model regarding program delivery and acceptability, appropriateness, and feasibility. Data were analyzed using descriptive statistics, linear regression, and qualitative methods.

RESULTS

This predominantly female (69 %) and White (64 %) sample (N = 61) with active epilepsy (66 % had a seizure in the past year) also had a higher portion of Black (32 %) participants. Analyses yielded significant differences in cognition, quality of life and self-management behaviors between the two groups at follow-up. Staff indicated the packaged intervention, remote delivery, trained coaches and investment of leaders/clinical staff as intervention benefits. Implementation barriers included difficulty contacting participants and mental health concerns. Program appropriateness and feasibility ratings were high; 98 % reported that they very much or moderately enjoyed working with their coach and would recommend the program to others.

CONCLUSION

HOBSCOTCH was effective in increasing cognition and quality of life in people with epilepsy in this replication study. A novel finding highlighted changes in the frequency of participants' self-management behaviors. These findings have implications for healthcare systems incorporating evidence-based self-management programs for their patients.