title: Predictors of trajectories of epilepsy-specific quality of life among children newly diagnosed with epilepsy.
abstract: OBJECTIVE
  The objective of this study was to identify two-year trajectories of epilepsy-specific health-related quality of life (HRQOL) among children newly diagnosed with epilepsy and to evaluate the predictive value of a comprehensive set of medical, psychosocial, and family factors.
  
  
  METHODS
  Ninety-four children with epilepsy (8.14 ± 2.37 years of age and 63% male) and their caregivers participated in this study. Caregivers completed the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE) and measures of psychological and family functioning at one month postdiagnosis. The QOLCE was also given at eight additional time points during the subsequent two years as a part of a large observational study in children with epilepsy. Adherence data were collected via MEMS TrackCaps, and medical information was collected through chart review.
  
  
  RESULTS
  Unique trajectories were identified for the overall QOLCE scale, as well as the subscales. Most trajectory models for the QOLCE subscales contained at least one at-risk trajectory for children, indicating that there is a subgroup of children experiencing poor long-term HRQOL. Health-related quality-of-life trajectories remained predominantly stable during the two-year period following treatment initiation. The number of AEDs, internalizing problems, and externalizing problems emerged as the most consistent predictors across the HRQOL domains.
  
  
  CONCLUSIONS
  Medical and psychosocial interventions, such as cognitive-behavioral strategies, should target modifiable factors (e.g., internalizing symptoms, externalizing symptoms, number of AEDs trialed) shortly after diagnosis to improve HRQOL for children with epilepsy over the course of their disease.
authors.affiliation: Center for Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7039, Cincinnati, OH 45229, USA.
authors.forename: Rachelle R
authors.initials: RR
authors.lastname: Ramsey
authors.affiliation: Center for Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7039, Cincinnati, OH 45229, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Loiselle
authors.affiliation: Center for Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7039, Cincinnati, OH 45229, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Rausch
authors.affiliation: Thomas E. Cook Counseling Center, Virginia Tech, 895 Washington St. SW, Blacksburg, VA 24061, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Harrison
authors.affiliation: Center for Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7039, Cincinnati, OH 45229, USA. Electronic address: avani.modi@cchmc.org.
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants
keywords: Children; Epilepsy; Quality of life; Trajectories