PMID- 22136077 OWN - NLM STAT- MEDLINE DCOM- 20120125 LR - 20191210 IS - 1528-1167 (Electronic) IS - 0013-9580 (Linking) VI - 52 IP - 12 DP - 2011 Dec TI - Determinants of health-related quality of life in pharmacoresistant epilepsy: results from a large multicenter study of consecutively enrolled patients using validated quantitative assessments. PG - 2181-91 LID - 10.1111/j.1528-1167.2011.03325.x [doi] AB - PURPOSE: To evaluate the relative contribution of demographic and epilepsy-related variables, depressive symptoms, and adverse effects (AEs) of antiepileptic drugs (AEDs) to health-related quality of life (HRQOL) in adults with pharmacoresistant epilepsy. METHODS: Individuals with epilepsy whose seizures failed to respond to at least one AED were enrolled consecutively at 11 tertiary referral centers. HRQOL was assessed by the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), AEs by the Adverse Event Profile (AEP), and depressive symptoms by the Beck Depression Inventory-II (BDI-II). Multivariate linear regression models were used to identify variables associated with QOLIE-31 total score and subscale scores. KEY FINDINGS: Of 933 enrolled individuals aged 16 years or older, 809 (87%) were able to complete the self-assessment instruments and were included in the analysis. Overall, 61% of the variance in QOLIE-31 scores was explained by the final model. The strongest predictors of HRQOL were AEP total scores (beta = -0.451, p < 0.001) and BDI-II scores (beta = -0.398, p < 0.001). These factors were also the strongest predictors of scores in each of the seven QOLIE-31 subscales. Other predictors of HRQOL were age (beta = -0.060, p = 0.008), lack of a driving license (beta = -0.053, p = 0.018), pharmacoresistance grade, with higher HRQOL in individuals who had failed only one AED (beta = 0.066, p = 0.004), and location of the enrolling center. Epilepsy-related variables (seizure frequency, occurrence of tonic-clonic seizures, age of epilepsy onset, disease duration) and number of AEDs had no significant predictive value on HRQOL. The AEP total score was the strongest negative predictor of HRQOL in the subgroup of 362 patients without depressive symptoms (BDI-II score <10), but even in this subgroup the BDI-II score was retained as a significant predictor. SIGNIFICANCE: In individuals with pharmacoresistant epilepsy, AEs of medication and depressive symptoms are far more important determinants of HRQOL than seizures themselves. When seizure freedom cannot be achieved, addressing depressive comorbidity and reducing the burden of AED toxicity is likely to be far more beneficial than interventions aimed at reducing the frequency of seizures. CI - Wiley Periodicals, Inc. (c) 2011 International League Against Epilepsy. FAU - Luoni, Chiara AU - Luoni C AD - Clinical Pharmacology Unit, University of Pavia, Pavia, Italy. FAU - Bisulli, Francesca AU - Bisulli F FAU - Canevini, Maria Paola AU - Canevini MP FAU - De Sarro, Giovambattista AU - De Sarro G FAU - Fattore, Cinzia AU - Fattore C FAU - Galimberti, Carlo Andrea AU - Galimberti CA FAU - Gatti, Giuliana AU - Gatti G FAU - La Neve, Angela AU - La Neve A FAU - Muscas, Giancarlo AU - Muscas G FAU - Specchio, Luigi Maria AU - Specchio LM FAU - Striano, Salvatore AU - Striano S FAU - Perucca, Emilio AU - Perucca E CN - SOPHIE Study Group LA - eng PT - Journal Article PT - Multicenter Study PL - United States TA - Epilepsia JT - Epilepsia JID - 2983306R RN - 0 (Anticonvulsants) SB - IM CIN - Nat Rev Neurol. 2012 Feb;8(2):59. PMID: 22249841 MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Anticonvulsants/*adverse effects MH - Cognition Disorders/drug therapy/epidemiology MH - Cohort Studies MH - *Epilepsy/drug therapy/epidemiology/psychology MH - Female MH - *Health Status MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - *Outcome Assessment, Health Care MH - Predictive Value of Tests MH - *Quality of Life MH - Reproducibility of Results MH - Self-Assessment MH - Surveys and Questionnaires MH - Young Adult FIR - Peruccaa, Emilio IR - Peruccaa E FIR - Baruzzic, Agostino IR - Baruzzic A FIR - De Sarrod, Giovambattista IR - De Sarrod G FIR - Peruccaa, Emilio IR - Peruccaa E FIR - Bonizzonia, Erminio IR - Bonizzonia E FIR - Fattorea, Cinzia IR - Fattorea C FIR - Francoa, Valentina IR - Francoa V FIR - Gattia, Giuliana IR - Gattia G FIR - Luonia, Chiara IR - Luonia C FIR - Malerbaa, Ambra IR - Malerbaa A FIR - Mazzucchellia, Iolanda IR - Mazzucchellia I FIR - Alexandre, Veriano IR - Alexandre V FIR - Beccariaf, Francesca IR - Beccariaf F FIR - Bisullic, Francesca IR - Bisullic F FIR - Cagdasf, Sophie IR - Cagdasf S FIR - Paola Canevinig, Maria IR - Paola Canevinig M FIR - Capovillaf, Giuseppe IR - Capovillaf G FIR - Ciampah, Clotilde IR - Ciampah C FIR - De Faziod, Salvatore IR - De Faziod S FIR - De Sarrod, Giovambattista IR - De Sarrod G FIR - Errichielloh, Luca IR - Errichielloh L FIR - Frassinef, Benedetta IR - Frassinef B FIR - Andrea Galimbertib, Carlo IR - Andrea Galimbertib C FIR - Gambardellad, Antonio IR - Gambardellad A FIR - Ganal, Simone IR - Ganal S FIR - Giordanoi, Lucio IR - Giordanoi L FIR - Guerrinil, Renzo IR - Guerrinil R FIR - Labated, Angelo IR - Labated A FIR - Briolag, Francesca La IR - Briolag FL FIR - Ladoganan, Marianna IR - Ladoganan M FIR - Lambertin, Paolo IR - Lambertin P FIR - Neven, Angela La IR - Neven AL FIR - Licchettac, Laura IR - Licchettac L FIR - Muscaso, Giancarlo IR - Muscaso G FIR - Papantoniop, Anna Maria IR - Papantoniop AM FIR - Pascarellah, Angelo IR - Pascarellah A FIR - Pellacanil, Simona IR - Pellacanil S FIR - Rosatio, Eleonora IR - Rosatio E FIR - Santullih, Lia IR - Santullih L FIR - Maria Specchiop, Luigi IR - Maria Specchiop L FIR - Strianor, Pasquale IR - Strianor P FIR - Strianoh, Salvatore IR - Strianoh S FIR - Tibertii, Alessandra IR - Tibertii A FIR - Tinuperc, Paolo IR - Tinuperc P FIR - Tozzib, Rossana IR - Tozzib R FIR - Trivisanop, Marina IR - Trivisanop M EDAT- 2011/12/06 06:00 MHDA- 2012/01/26 06:00 CRDT- 2011/12/06 06:00 PHST- 2011/12/06 06:00 [entrez] PHST- 2011/12/06 06:00 [pubmed] PHST- 2012/01/26 06:00 [medline] AID - 10.1111/j.1528-1167.2011.03325.x [doi] PST - ppublish SO - Epilepsia. 2011 Dec;52(12):2181-91. doi: 10.1111/j.1528-1167.2011.03325.x.