title: Is antiepileptic drug withdrawal status related to quality of life in seizure-free adult patients with epilepsy?
abstract: OBJECTIVE
  This study aimed to determine factors that influence the quality of life (QOL) of seizure-free adult patients with epilepsy in western China and address whether these determinants vary by antiepileptic drug (AED) withdrawal.
  
  
  METHODS
  A cross-sectional study was conducted in the epilepsy outpatient clinic of West China Hospital, Sichuan University. Patients with epilepsy who were aged at least 18years and seizure-free for at least 12months were interviewed using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31); the National Hospital Seizure Severity Scale (NHS3); the Liverpool Adverse Events Profile (LAEP); the Social Support Rating Scale (SSRS); the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Questionnaire; and the Scale of Knowledge and Attitudes Toward Epilepsy. Eligible patients were divided into two groups: the nonwithdrawal group and the withdrawal group. The independent-samples t-test was used to compare the QOL between the groups, and linear regression analysis was used to explain the variance of their QOL.
  
  
  RESULTS
  One hundred and eighty-seven (135 nonwithdrawal and 52 withdrawal) patients were included in the analysis. The QOLIE-31 overall score of the nonwithdrawal group was lower than that of the withdrawal group (p<0.01). The LAEP score was the strongest predictor of the QOLIE-31 overall score of all subjects, explaining 26.9% of the variance. The second strongest predictor was the SSRS score, explaining 12.9%, and the other predictors were the NHS3 score (5.2%), education level (2.3%), age (1.5%), and marriage (1.0%). Furthermore, the strongest predictors in the nonwithdrawal group were the LAEP and SSRS scores, while in the withdrawal group, the strongest predictors were stigma scores and employment.
  
  
  CONCLUSIONS
  Among the seizure-free adult patients with epilepsy, those with AED withdrawal experienced better QOL than those continuing AED treatment. Furthermore, the determinants of QOL varied by AED withdrawal. Individual strategies to optimize QOL should be developed based on these differences.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hong
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Jiani
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China. Electronic address: zhoudong66@yahoo.de.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002681:China; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D012640:Seizures / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000523:psychology*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Determinant; Epilepsy; Quality of life; Seizure-free; Withdrawal