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Impact of a Seizure Disorder Disease Management Program on Patient-Reported Quality of Life

机译：癫痫病疾病管理计划对患者报告的生活质量的影响

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The objective of this study was to evaluate the impact of a comprehensive, multifaceted disease management program on self-reported quality of life (QOL) for adult patients with epilepsy. The study (1996-2000) employed a quasi-experimental research design in which primary care clinics in a southwestern integrated delivery system were assigned to either the intervention or comparison group. The impact evaluation involved a comparison of responses to a validated QOL survey before and after a disease management intervention for adult health plan members with epilepsy. The intervention consisted of both formal provider training and associated tools and reinforcements as well as direct-to-patient interventions, including a comprehensive education booklet, a seizure diary, a patient education class, and a resource list. Pre-post analysis utilizing paired t-tests was conducted to identify any pre-post differences in QOL for both the intervention and comparison group patients, as measured by the seven specific domains of the epilepsy QOL instrument (QOLIE-31). The intervention group patients showed statistically significant positive changes in two QOL domains: Seizure Worry (p < 0.001) and Emotional Well-being (p < 0.05). One other domain, Overall Quality of Life, showed improvement in the intervention group that approached statistical significance (p < 0.06). There were no statistically significant changes for the comparison group. A well-designed, comprehensive disease management program can improve patient empowerment and coordination of care between the patient and provider, which resulted in an improvement in quality of life, one of the most central patient outcomes in this difficult disease.
机译：这项研究的目的是评估全面的，多方面的疾病管理计划对成人癫痫患者自我报告的生活质量（QOL）的影响。该研究（1996年至2000年）采用了一项准实验研究设计，该研究将西南综合分娩系统中的初级保健诊所分配给干预组或比较组。影响评估涉及对成人癫痫健康计划成员进行疾病管理干预之前和之后对经过验证的QOL调查的响应的比较。干预措施包括正式的医疗服务提供者培训和相关的工具与强化措施，以及针对患者的干预措施，包括综合教育手册，癫痫发作日记，患者教育课和资源清单。利用配对t检验进行事前分析，以确认干预和比较组患者的QOL事前差异，如通过癫痫QOL仪器的七个特定域（QOLIE-31）所测量的。干预组患者在两个QOL域中表现出统计学上显着的阳性变化：癫痫困扰（p <0.001）和情绪健康（p <0.05）。另一个领域，即“总体生活质量”显示干预组的改善达到了统计学显着性（p <0.06）。比较组没有统计学上的显着变化。精心设计的全面疾病管理计划可以改善患者的权能并改善患者与提供者之间的护理协调，从而改善生活质量，这是这种困难疾病中最重要的患者结果之一。

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