Health-related quality of life and associated factors among patients living with epilepsy of Mekelle City Hospitals, Northern Ethiopia: a multicenter observational study

Abstract

Epilepsy profoundly affects the physical, emotional, cognitive, and socioeconomic well-being of patients living with epilepsy. In resource-limited settings, patients living with epilepsy experience markedly reduced health-related quality of life (HRQoL) due to treatment gaps, stigma, social isolation, and misconceptions about the disease and its management. Despite the significant impact of epilepsy on HRQoL, data on its magnitude and determinants remain scarce in Ethiopia, especially within the current study setting. Thus, this study aimed to assess the HRQoL and its predictors among adult patients living with epilepsy in three selected hospitals. A multicenter observational study was conducted from June 1 to September 30, 2023, to assess HRQoL among adult patients living with epilepsy. Participants were recruited using systematic random sampling. Data were collected via face-to-face interviews employing the European Quality of Life Five-Dimension Five-Level (EQ-5D-5L) and European Quality of Life Visual Analog Scale (EQ-VAS) instruments. Descriptive and a multivariate Tobit regression model were used to analyze the data . The majority of study participants (248, 70.7%) were aged 18–44 years, with a mean age of 37.98 ± 14.27 years (mean ± SD). The Cronbach’s alpha for the five EQ-5D-5L dimensions was 0.744, indicating acceptable internal consistency reliability.Over half of the participants (179, 51%) reported poor HRQoL. The median (interquartile range, IQR) values for the EQ-5D-5L utility score and EQ-VAS were 0.774 (0.56–0.85) and 65 (50–80), respectively. In the EQ-5D-5L descriptive system, anxiety/depression was the most frequently reported health problem (342, 97.4%). Age over 60 years (β = -0.21, 95% CI: -0.402 to -0.017) and frequent seizure episodes before treatment (β = -0.0054, 95% CI: -0.0102 to -0.006) were identified as negative predictors of HRQoL. Conversely, the absence of comorbidities (β = 0.095, 95% CI: 0.012 to 0.178) and the lack of seizure relapse (β = 0.062, 95% CI: -0.0007 to 0.125) were positively associated with improved HRQoL. A considerable proportion of patients living with epilepsy experience poor HRQoL, particularly due to anxiety and depression. Key socio-demographic and clinical factors, including age, employment status, comorbidities, seizure frequency, and seizure control, significantly influence quality of life, highlighting the need for comprehensive and patient-centered epilepsy care.