Correlates of health-related quality of life in children with drug resistant epilepsy

Lauryn Conway; Mary Lou Smith; Mark A Ferro; Kathy N Speechley; Mary B Connoly; O Carter Snead; Elysa Widjaja; PEPSQOL Study Team

doi:10.1111/epi.13441

Correlates of health-related quality of life in children with drug resistant epilepsy

Epilepsia. 2016 Aug;57(8):1256-64. doi: 10.1111/epi.13441. Epub 2016 Jun 28.

Authors

Lauryn Conway^{1

2}, Mary Lou Smith^{1

2}, Mark A Ferro³, Kathy N Speechley⁴, Mary B Connoly⁵, O Carter Snead⁶, Elysa Widjaja^{6

7}; PEPSQOL Study Team

Collaborators

PEPSQOL Study Team:
Cristina Go, Rajesh Ramachandrannair, Lionel Carmant, Jeffrey Buchhalter, Paula Brna, Fran Booth, Salah Almubarak, Simon Levin

Affiliations

¹ Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
³ Departments of Psychiatry and Behavioural Neurosciences and Pediatrics, McMaster University, Hamilton, Ontario, Canada.
⁴ Departments of Paediatrics, Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada.
⁵ Division of Neurology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
⁶ Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.
⁷ Division of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.

PMID: 27350597
DOI: 10.1111/epi.13441

Abstract

Objective: Health-related quality of life (HRQL) is compromised in children with epilepsy. The current study aimed to identify correlates of HRQL in children with drug resistant epilepsy.

Methods: Data came from 115 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Individual, clinical, and family factors were evaluated. HRQL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE), a parent-rated epilepsy-specific instrument, with composite scores ranging from 0 to 100. A series of univariable linear regression analyses were conducted to identify significant associations with HRQL, followed by a multivariable regression analysis.

Results: Children had a mean age of 11.85 ± 3.81 years and 65 (56.5%) were male. The mean composite QOLCE score was 60.18 ± 16.69. Child age, sex, age at seizure onset, duration of epilepsy, caregiver age, caregiver education, and income were not significantly associated with HRQL. Univariable regression analyses revealed that a higher number of anti-seizure medications (p = 0.020), lower IQ (p = 0.002), greater seizure frequency (p = 0.048), caregiver unemployment (p = 0.010), higher caregiver depressive and anxiety symptoms (p < 0.001 for both), poorer family adaptation, fewer family resources, and a greater number of family demands (p < 0.001 for all) were associated with lower HRQL. Multivariable regression analysis showed that lower child IQ (β = 0.20, p = 0.004), fewer family resources (β = 0.43, p = 0.012), and caregiver unemployment (β = 6.53, p = 0.018) were associated with diminished HRQL in children.

Significance: The results emphasize the importance of child cognition and family variables in the HRQL of children with drug-resistant epilepsy. The findings speak to the importance of offering comprehensive care to children and their families to address the nonmedical features that impact on HRQL.

Keywords: Family; Health-related quality of life; Pediatric epilepsy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Caregivers / psychology
Child
Child, Preschool
Drug Resistant Epilepsy / psychology*
Drug Resistant Epilepsy / surgery
Female
Health Status*
Humans
Male
Mental Health
Quality of Life / psychology*
Severity of Illness Index
Socioeconomic Factors
Statistics as Topic*
Surveys and Questionnaires

Grants and funding

MOP-133708/CIHR/Canada