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. 2018 Mar 1;3(3):CD006245.
doi: 10.1002/14651858.CD006245.pub4.

Care delivery and self-management strategies for children with epilepsy

Nigel Fleeman  1 , Peter M Bradley
Affiliations

Care delivery and self-management strategies for children with epilepsy

Nigel Fleeman et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: In response to criticism that epilepsy care for children has little impact, healthcare professionals and administrators have developed various service models and strategies to address perceived inadequacies.

Objectives: To assess the effects of any specialised or dedicated intervention for epilepsy versus usual care in children with epilepsy and in their families.

Search methods: We searched the Cochrane Epilepsy Group Specialized Register (27 September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 9) in the Cochrane Library, MEDLINE (1946 to 27 September 2016), Embase (1974 to 27 September 2016), PsycINFO (1887 to 27 September 2016) and CINAHL Plus (1937 to 27 September 2016). In addition, we also searched clinical trials registries for ongoing or recently completed trials, contacted experts in the field to seek information on unpublished and ongoing studies, checked the websites of epilepsy organisations and checked the reference lists of included studies.

Selection criteria: We included randomised controlled trials (RCTs), cohort studies or other prospective studies with a (matched or unmatched) control group (controlled before-and-after studies), or time series studies.

Data collection and analysis: We used standard methodological procedures expected by Cochrane.

Main results: Our review included six interventions reported through seven studies (of which five studies were designed as RCTs). They reported on different education and counselling programmes for children and parents; teenagers and parents; or children, adolescents and their parents. Each programme showed some benefits for the well-being of children with epilepsy, but all had methodological flaws (e.g. in one of the studies designed as an RCT, randomisation failed), no single programme was independently evaluated with different study samples and no interventions were sufficiently homogeneous enough to be included in a meta-analysis,.

Authors' conclusions: While each of the programmes in this review showed some benefit to children with epilepsy, their impacts were extremely variable. No programme showed benefits across the full range of outcomes, and all studies had major methodological problems. At present there is insufficient evidence in favour of any single programme.

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Conflict of interest statement

NF: none known.

PB: none known.

Figures

1
1
Study flow diagram (original and updated searches).
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

Glueckauf 2002 {published data only}
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References to studies excluded from this review

Austin 2002 {published data only}
    1. Austin JK, McNelis AM, Shore CP, Dunn DW, Musick B. A feasibility study of a family seizure management program: "Be Seizure Smart". Journal of Neuroscience Nursing 2002;34(1):30‐7.
Hallfahrt 2007 {published data only}
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Ibinda 2014 {published data only}
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Li 2013 {published data only}
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Mar 2005 {published data only}
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Modi 2013 {published data only}
    1. Modi Avani C, Guilfoyle Shanna M, Rausch Joseph. Preliminary feasibility, acceptability, and efficacy of an innovative adherence intervention for children with newly diagnosed epilepsy. Journal of Pediatric Psychology 2013;38(6):605‐16. - PMC - PubMed
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References to studies awaiting assessment

NCT02349529 {published data only}
    1. NCT02349529. An exploratory RCT of a psychosocial group intervention for epilepsy [An exploratory randomised controlled trial of a manualised psychosocial group intervention for young people with epilepsy (PIE)]. clinicaltrials.gov/ct2/show/NCT02349529 (first received 29 January 2015).

References to ongoing studies

IRCT2015060122514N1 {published data only}
    1. IRCT2015060122514N1. The effect of self‐care education based on short message service in adolescents with epilepsy [Comparison of self‐care education based on short message service and pamphlet on self‐efficacy and adherence to the medication regimen in adolescents with epilepsy]. http://en.irct.ir/trial/19406 Registration date: 27 October 2015.

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References to other published versions of this review

Fleeman 2015
    1. Fleeman N, Bradley PM, Lindsay B. Care delivery and self management strategies for children with epilepsy. Cochrane Database of Systematic Reviews 2015, Issue 12. [DOI: 10.1002/14651858.CD006245] - DOI - PubMed
Lindsay 2006
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Lindsay 2010
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