title: Relationship between seizure frequency and costs and quality of life of outpatients with partial epilepsy in France, Germany, and the United Kingdom.
abstract: OBJECTIVE
  The relationship between seizure frequency and both health care costs and quality of life (QOL) was investigated in a retrospective, cross-sectional, multicenter study in France, Germany, and the United Kingdom.
  
  
  METHODS
  Three hundred outpatients with stable partial epilepsy were approximately evenly distributed among five seizure-frequency groups, ranging from seizure-free in the last 3 months (group 1) to daily seizures (group 5). Economic data, obtained through patient interviews and record abstraction, comprised direct medical costs, direct nonmedical costs, and indirect costs for the preceding 3 months. Total societal costs in the three countries were pooled and converted to United States dollar equivalents. QOL was assessed through a self-administered questionnaire, the Functional Status Questionnaire (FSQ).
  
  
  RESULTS
  Mean total costs increased from $780 in group 1 to $2,171 in group 5 (p = 0.0001), with significant increases in each cost category as seizure frequency increased. Greater seizure frequency also significantly (p = 0.0270) correlated with lower employment rates, which ranged from 57% in group 1 to 30% in group 5. QOL declined as seizure frequency increased. Particularly affected were basic and intermediate activities of daily living (ADL), mental health, social activity, and feeling about health.
  
  
  CONCLUSIONS
  The study results show that higher seizure frequencies are associated with higher direct and indirect costs and with reduced QOL for patients with epilepsy.
authors.affiliation: iMTA, Erasmus University Rotterdam, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: van Hout
authors.forename: D
authors.initials: D
authors.lastname: Gagnon
authors.forename: E
authors.initials: E
authors.lastname: Souêtre
authors.forename: S
authors.initials: S
authors.lastname: Ried
authors.forename: C
authors.initials: C
authors.lastname: Remy
authors.forename: G
authors.initials: G
authors.lastname: Baker
authors.forename: P
authors.initials: P
authors.lastname: Genton
authors.forename: H
authors.initials: H
authors.lastname: Vespignani
authors.forename: P
authors.initials: P
authors.lastname: McNulty
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D017028:Caregivers / Q000191:economics; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004180:Direct Service Costs; D004828:Epilepsies, Partial / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012944:Social Support; D014186:Transportation / Q000191:economics; D006113:United Kingdom / Q000453:epidemiology