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Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention

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Abstract

Background

Improving health-related quality of life (HRQoL) among people with epilepsy (PWE) has become the focus of various treatment programmes and behavioural interventions which continue to be challenging to both patients and healthcare professionals.

Aims and objectives

To investigate the impact of SMS-based epilepsy education programme on PWE’s HRQoL status and to determine the predictors for good HRQoL.

Methods

Eligible epilepsy out-patients from three public hospitals in East Coast Peninsular Malaysia were randomized into two groups: intervention (IG) and control (CG). Patients in the CG were supplied with only printed epilepsy educational module, while those in the IG additionally received short message service (SMS) from the Mobile Epilepsy Educational System (MEES). The Malay Quality of Life in Epilepsy Inventory-30 (MQOLIE-30) was utilized for HRQoL assessment. Descriptive statistics, paired t test, analysis of covariance and multiple logistic regression were employed for data analyses (SPSS 16).

Results

One hundred and forty-four PWE were recruited for the study (age = 30.5 ± 11.8; unmarried = 60.4 %; education level ≤ SPM/Cambridge O’ level = 76.4 %; illness duration > 5 years = 51.1 %). After controlling for possible confounders, IG exhibited positive changes in HRQoL profile compared to CG particularly in Seizure Worry, Overall Quality of Life, Emotional Well-Being, Social Functioning and Overall Score (p < 0.05). After adjusting for covariates, being employed and receiving additional SMS-based epilepsy education programme emerged as the significant predictors of good HRQoL among PWE.

Conclusion

Receiving continuous SMS-based epilepsy information from the MEES seemed to generate positive impacts on PWE’s overall HRQoL. This study has provided a basis for future innovations to inspire efforts in ensuring the welfare and HRQoL of PWE and their families.

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Acknowledgments

We wish to thank the Director General of Health, Malaysia, for permission to publish this paper and the hospital directors, heads of Neurology Department (Dr. Zariah Abd Aziz, Dr. Sapari Satwi and Dr. Mahiran Mustafa) and staff of Hospital Sultanah Nur Zahirah (Sr. Hasmah Sabur and Mrs. Rohani Mohammad), Hospital Tuanku Ampuan Afzan (Sr. Masnah Meon and SN Mazilah Abdullah) and Hospital Raja Perempuan Zainab II (SN Nor Hayati Yusoff and Mr. Zamzuki Mat Zali) for their cooperation in ensuring the success of this study. Our gratitude also goes to the Faculty of Medicine and Health Sciences, UniSZA, all participants and their families for supporting our study. This study was supported by the Centre of Research Management and Innovation of UniSZA for its financial support [grant no: UDM/10/BR (029)].

Ethical approval

The study was approved by the Medical Research and Ethics Committee (MREC) of the Ministry of Health, Malaysia [reference: NMRR-10-359-5640/(2) dlm. KKM/NIHSEC/08/0804/P10-158].

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Authors and Affiliations

  1. Centre for Clinical and Quality of Life Studies (CCQoLS) Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kampus Kota, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Malaysia

    Pei Lin Lua & Widiasmoro Selamat Neni

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  1. Pei Lin Lua
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Correspondence to Pei Lin Lua.

Appendix

Appendix

The sample size calculation was based on sample size determination in experimental studies. The formula was as follows:

$$ n = \frac{{2\sigma^{2} (Z_{\alpha } + Z_{\beta } )^{2} }}{{\Updelta^{2} }} $$

where α was level of significance equal to 0.01 with 90 % power of study (1 − β); β was probability of wrongly not rejecting the null hypothesis when null hypothesis is false (10 % or 0.1); Z α was value from the standard normal distribution corresponding to α which was equal to 2.58; Z β was value from the standard normal distribution corresponding to β which was equal to 1.28; Δ was value of the clinically important mean difference to detect which was equal to 11.8, and σ was standard deviation of population which was equal to 15.78.

Hence,

$$ \begin{aligned} n & = \frac{{2 \times 15.78^{2} \left( {2.58 + 1.28} \right)^{2} }}{{11.8^{2} }} \\ & = 53.29\sim 54 \\ \end{aligned} $$

According to the formula, the required sample size per group was 54. For two groups, the sample size needed was 108. After considering a 20 % dropout, the final sample size required for this study was 130, that is, 65 patients per group.

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Lua, P.L., Neni, W.S. Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention. Qual Life Res 22, 2123–2132 (2013). https://doi.org/10.1007/s11136-013-0352-6

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