Evidence map›Paper›PMID 29658989›Full record

Trial reportEpilepsia2018

The effectiveness of a group self-management education course for adults with poorly controlled epilepsy, SMILE (UK): A randomized controlled trial.

Leone Ridsdale, Gabriella Wojewodka, Emily J Robinson, Adam J Noble, Myfanwy Morgan, Stephanie J C Taylor, Paul McCrone, Mark P Richardson, Gus Baker, Sabine Landau and 1 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Epilepsia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Review
  7. Article
  8. Recent Advances in Neuroimaging of Epilepsy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021
    Review
  9. Review
  10. Psychological treatments for people with epilepsy.The Cochrane database of systematic reviews · 2020
    Review
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Leone RidsdaleDepartment of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology, and Neuroscience, Academic Neuroscience Centre, King's College London, London, UK.ORCID 0000-0002-2234-2859
Gabriella WojewodkaDepartment of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology, and Neuroscience, Academic Neuroscience Centre, King's College London, London, UK.ORCID 0000-0003-4635-4800
Emily J RobinsonDepartment of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.ORCID 0000-0002-6692-5415
Adam J NobleDepartment of Psychological Sciences, Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, UK.ORCID 0000-0002-8070-4352
Myfanwy MorganInstitute of Pharmaceutical Science, Waterloo Campus, King's College London, London, UK.ORCID 0000-0001-5532-8941
Stephanie J C TaylorCentre for Primary Care and Public Health, Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID 0000-0001-7454-6354
Paul McCroneKing's Health Economics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.ORCID 0000-0001-7001-4502
Mark P RichardsonDepartment of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology, and Neuroscience, Academic Neuroscience Centre, King's College London, London, UK.ORCID 0000-0001-8925-3140
Gus BakerDepartment of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.ORCID 0000-0002-5736-605X
Sabine LandauDepartment of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.ORCID 0000-0002-3615-8075
Laura H GoldsteinDepartment of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.ORCID 0000-0001-9387-3035
King's College London · GBUniversity of Liverpool · GBQueen Mary University of London · GB

Funding

Department of Health 09/165/01
6 · The paper itself

Abstract

objectiveEpilepsy is one of the most common neurological conditions affecting about 1% of adults. Up to 40% of people with epilepsy (PWE) report recurring seizures while on medication. And optimal functioning requires good self-management. Our objective was to evaluate a group self-management education courses for people with epilepsy and drug-resistant seizures by means of a multicenter, pragmatic, parallel group, randomized controlled trial.

methodsWe recruited adults with epilepsy, having ≥2 seizures in the prior 12 months, from specialist clinics. Consenting participants were randomized 1:1 to a group course or treatment as usual. The primary outcome measure was quality of life 12 months after randomization using Quality of Life 31-P (QOLIE-31-P). Secondary outcome measures were seizure frequency and recency, psychological distress, impact and stigma of epilepsy, self-mastery, medication adherence, and adverse effects. Analysis of outcomes followed the intention-to-treat principle using mixed-effects regression models.

resultsWe enrolled 404 participants (intervention: n = 205, control: n = 199) with 331 (82%) completing 12-month follow-up (intervention: n = 163, control: n = 168). Mean age was 41.7 years, ranging from 16 to 85, 54% were female and 75% were white. From the intervention arm, 73.7% attended all or some of the course. At 12-month follow-up, there were no statistically significant differences between trial arms in QOLIE-31-P (intervention mean: 67.4, standard deviation [SD]: 13.5; control mean: 69.5, SD 14.8) or in secondary outcome measures. SIGNIFICANCE: This is the first pragmatic trial of group education for people with poorly controlled epilepsy. Recruitment, course attendance, and follow-up rates were higher than expected. The results show that the primary outcome and quality of life did not differ between the trial arms after 12 months. We found a high prevalence of felt-stigma and psychological distress in this group of people with drug-resistant seizures. To address this, social and psychological interventions require evaluation, and may be necessary before or alongside self-management-education courses.

Indexed as

Quality of LifeAdolescentAdultAgedAged, 80 and overDrug Resistant EpilepsyFemaleHumansMaleMiddle AgedPatient Education as TopicSelf-ManagementYoung Adulteducationepilepsyquality of liferandomized controlled trialself-management

Identifiers

PMID29658989
PMCPMC5969309
OpenAlexW2802637072

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.