Factors Influencing Health-Related Quality of Life in People With Epilepsy in India: A Systematic Review and Meta-Analysis
Author(s)
Ravi chakali, M. Pharm1, Sri Harsha Chalasani2, shasthara Paneyala3, Jehath Syed4, Varukolu Suresh5.
1Student, Dept. of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore 15, Karnataka, Mysore, India, 2JSS College of Pharmacy, Mysuru, Mysuru, India, 3India, 4JSS Collage of Pharmacy, JSSAHER, Mysore, India, Pune, India, 5Independent, India.
1Student, Dept. of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore 15, Karnataka, Mysore, India, 2JSS College of Pharmacy, Mysuru, Mysuru, India, 3India, 4JSS Collage of Pharmacy, JSSAHER, Mysore, India, Pune, India, 5Independent, India.
OBJECTIVES: Epilepsy is a chronic neurological disorder characterized by recurrent seizures that can significantly affect an individual's physical and emotional well-being. This review sought to assess the factors affecting health-related quality of life (HRQOL) of individuals with epilepsy in India.
METHODS: A PRISMA compliant systematic literature review (SLR) was conducted to identify the English-language observational studies published from January 1, 2014, to August 11, 2024. The search was conducted in PubMed, Embase and Google scholar with country restriction to India. Meta-analysis performed using R (3.3.0). Using a random-effects model, standardized mean differences (SMD) with 95% confidence intervals were calculated to account for heterogeneity. Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies.
RESULTS: This SLR included 24 studies, with the majority using a cross-sectional design (n = 17), and a total sample size of 4,629 participants, predominantly male (61.33%). QOLIE-31 is the most used instrument. People with epilepsy showed lower QOL than the general population. Treatment with a single drug (monotherapy) demonstrated significantly better QOL scores than polytherapy (SMD = 0.77, 95% CI: 0.41-1.13). Subgroup analysis of QOLIE-31 subscales favoured monotherapy, with cognitive functioning showing the largest effect (SMD = 1.93; 95% CI: 0.62, 4.48), and seizure worry (SMD = 1.21; 95% CI: 1.03, 2.45) being the most impacted domain. Generalized seizures, psychiatric comorbidity, lower education, earlier seizure onset, and prolonged AED (antiepileptic drug) treatment were independent predictors of poor QOL. New AEDs showed slight improvements in QOL compared with old AEDs.
CONCLUSIONS: These findings highlight the need for a comprehensive approach to epilepsy management that addresses both seizure control and psychosocial factors. QOL, a crucial element in epilepsy care, can be improved through patient education about their condition, treatment, side effects, and medication adherence.
METHODS: A PRISMA compliant systematic literature review (SLR) was conducted to identify the English-language observational studies published from January 1, 2014, to August 11, 2024. The search was conducted in PubMed, Embase and Google scholar with country restriction to India. Meta-analysis performed using R (3.3.0). Using a random-effects model, standardized mean differences (SMD) with 95% confidence intervals were calculated to account for heterogeneity. Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies.
RESULTS: This SLR included 24 studies, with the majority using a cross-sectional design (n = 17), and a total sample size of 4,629 participants, predominantly male (61.33%). QOLIE-31 is the most used instrument. People with epilepsy showed lower QOL than the general population. Treatment with a single drug (monotherapy) demonstrated significantly better QOL scores than polytherapy (SMD = 0.77, 95% CI: 0.41-1.13). Subgroup analysis of QOLIE-31 subscales favoured monotherapy, with cognitive functioning showing the largest effect (SMD = 1.93; 95% CI: 0.62, 4.48), and seizure worry (SMD = 1.21; 95% CI: 1.03, 2.45) being the most impacted domain. Generalized seizures, psychiatric comorbidity, lower education, earlier seizure onset, and prolonged AED (antiepileptic drug) treatment were independent predictors of poor QOL. New AEDs showed slight improvements in QOL compared with old AEDs.
CONCLUSIONS: These findings highlight the need for a comprehensive approach to epilepsy management that addresses both seizure control and psychosocial factors. QOL, a crucial element in epilepsy care, can be improved through patient education about their condition, treatment, side effects, and medication adherence.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR97
Topic
Clinical Outcomes, Patient-Centered Research, Study Approaches
Topic Subcategory
Patient Behavior and Incentives, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addition), Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas