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      EPICAP: intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia. Ensayo clínico aleatorizado Translated title: EPICAP: educational intervention using instructional clips in patients with epilepsy. A randomised clinical trial

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          Abstract

          Objetivos.

          La educación sanitaria en pacientes con epilepsia influye positivamente en el autocontrol de la enfermedad, mejora su pronóstico y favorece el bienestar del paciente. El objetivo de este estudio fue evaluar una intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia en una unidad de monitorización videoelectroencefalográfica.

          Sujetos y métodos.

          Es un ensayo clínico aleatorizado con dos grupos (intervención y control). Se reclutó a pacientes adultos con epilepsia que ingresaron en la unidad de monitorización videoelectroencefalográfica. Se crearon nueve vídeos sobre el diagnóstico y el tratamiento de la epilepsia, y recomendaciones de estilo de vida, que se administraron al grupo de intervención durante el ingreso. Se evaluó el conocimiento del paciente sobre su enfermedad con un cuestionario diseñado específicamente para este estudio. Se realizó una evaluación previa en el inicio del estudio, en el alta hospitalaria y a los tres meses, y se comparó el conocimiento sobre la epilepsia en ambos grupos en cada momento del estudio.

          Resultados.

          Se incluyó a 66 pacientes, con edad media de 39 ± 14,7 años (rango: 17-76) y una mediana de 8 años de evolución de la enfermedad (rango: 1-60 años). Un 53% eran mujeres. El tipo de epilepsia más frecuente fue el focal (95,5%). La puntuación media en el test preintervención fue de 57,2 ± 15,3. Los pacientes que recibieron la intervención educativa mostraron mejores puntuaciones en el postest en el alta hospitalaria (81,8 ± 11,2 frente a 62,8 ± 13,7; p = 0,001) y a los tres meses (76 ± 9,6 frente a 63,2 ± 12,8; p = 0,001).

          Conclusiones.

          La intervención educativa EPICAP mediante píldoras audiovisuales mejora de forma significativa el conocimiento de los pacientes sobre aspectos diagnósticos, terapéuticos y estilo de vida relacionados con la epilepsia.

          Translated abstract

          Aims.

          In patients with epilepsy health education has a positive influence on self-management of the disease, improves prognosis and enhances patient well-being. The aim of this study was to evaluate an educational intervention using instructional clips in patients with epilepsy in a video-electroencephalographic monitoring unit.

          Subjects and methods.

          We conducted a randomised clinical trial with two groups (intervention and control). Adult patients with epilepsy admitted to the video-electroencephalographic monitoring unit were recruited. Nine videos about the diagnosis and treatment of epilepsy, together with recommendations on lifestyle, were produced and administered to the intervention group while admitted. Patients’ knowledge of their disease was assessed by means of a questionnaire designed specifically for this study. A pre-assessment was conducted at the beginning of the study, at hospital discharge and at three months, and the knowledge of epilepsy in the two groups was compared at each time considered in the study.

          Results.

          Sixty-six patients were included, with a mean age of 39 ± 14.7 years (range: 17-76) and a median of 8 years since disease onset (range: 1-60 years). Fifty-three per cent of the patients were women. Focal epilepsy was the most frequent type (95.5%). The mean score on the pre-intervention test was 57.2 ± 15.3. Patients who received the educational intervention showed better post-test scores at discharge from hospital (81.8 ± 11.2 versus 62.8 ± 13.7; p = 0.001) and at three months (76 ± 9.6 versus 63.2 ± 12.8; p = 0.001).

          Conclusions.

          The EPICAP educational intervention using instructional clips significantly improves patients’ knowledge of epilepsy-related diagnostic, therapeutic and lifestyle issues.

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          Most cited references24

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          ILAE official report: a practical clinical definition of epilepsy.

          Epilepsy was defined conceptually in 2005 as a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. This definition is usually practically applied as having two unprovoked seizures >24 h apart. The International League Against Epilepsy (ILAE) accepted recommendations of a task force altering the practical definition for special circumstances that do not meet the two unprovoked seizures criteria. The task force proposed that epilepsy be considered to be a disease of the brain defined by any of the following conditions: (1) At least two unprovoked (or reflex) seizures occurring >24 h apart; (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; (3) diagnosis of an epilepsy syndrome. Epilepsy is considered to be resolved for individuals who either had an age-dependent epilepsy syndrome but are now past the applicable age or who have remained seizure-free for the last 10 years and off antiseizure medicines for at least the last 5 years. "Resolved" is not necessarily identical to the conventional view of "remission or "cure." Different practical definitions may be formed and used for various specific purposes. This revised definition of epilepsy brings the term in concordance with common use. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.
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            Epilepsy in adults

            Epilepsy is one of the most common serious brain conditions, affecting over 70 million people worldwide. Its incidence has a bimodal distribution with the highest risk in infants and older age groups. Progress in genomic technology is exposing the complex genetic architecture of the common types of epilepsy, and is driving a paradigm shift. Epilepsy is a symptom complex with multiple risk factors and a strong genetic predisposition rather than a condition with a single expression and cause. These advances have resulted in the new classification of epileptic seizures and epilepsies. A detailed clinical history and a reliable eyewitness account of a seizure are the cornerstones of the diagnosis. Ancillary investigations can help to determine cause and prognosis. Advances in brain imaging are helping to identify the structural and functional causes and consequences of the epilepsies. Comorbidities are increasingly recognised as important aetiological and prognostic markers. Antiseizure medication might suppress seizures in up to two-thirds of all individuals but do not alter long-term prognosis. Epilepsy surgery is the most effective way to achieve long-term seizure freedom in selected individuals with drug-resistant focal epilepsy, but it is probably not used enough. With improved understanding of the gradual development of epilepsy, epigenetic determinants, and pharmacogenomics comes the hope for better, disease-modifying, or even curative, pharmacological and non-pharmacological treatment strategies. Other developments are clinical implementation of seizure detection devices and new neuromodulation techniques, including responsive neural stimulation.
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              The epidemiology of drug-resistant epilepsy: A systematic review and meta-analysis.

              The definition of drug-resistant epilepsy (DRE) affects case identification and treatment, and impacts prevalence or incidence estimates and health burden estimation in epidemiology. The objective of this systematic review is to evaluate the consistency between definitions of DRE in the literature and the official definition in the International League Against Epilepsy (ILAE) guidelines, and to estimate the incidence, prevalence, and risk factors for DRE.
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                Author and article information

                Journal
                Rev Neurol
                Rev Neurol
                RN
                Revista de Neurología
                EVIDENZE (Spain )
                0210-0010
                1576-6578
                2023
                01 November 2023
                : 77
                : 9
                : 215-222
                Affiliations
                [1] originalGrupo de investigación Multidisciplinario de Enfermería. Vall d’Hebron Institut de Recerca (VHIR). Hospital Universitario Vall d’Hebron. Barcelona, España normalizedHospital Universitario Vall d’Hebron orgnameHospital Universitario Vall d’Hebron Barcelona España
                Author notes
                Correspondencia: Dra. Nadia Puertas Porrino. Grupo de investigación Multidisciplinario de Enfermería. Vall d’Hebron Institut de Recerca (VHIR). Hospital Universitario Vall d’Hebron. Passeig Vall d’Hebron, 119-121. E-08035 Barcelona. E-mail: nadia.puertas@ 123456vallhebron.cat

                Conflicto de intereses: E.F.H. declara financiación a proyectos de investigación y honorarios de UCB Pharma, Esteve laboratorios, Eisai Inc., BIAL Pharmaceutical, GW Pharmaceuticals, Angelini Pharma y Sanofi Genzyme. E.S.P. declara financiación a proyectos de investigación de UCB Pharma, Angelini Pharma y Eisai Inc.; y honorarios de UCB Pharma, Esteve Laboratorios, Eisai Inc., BIAL Pharmaceutical, Angelini Pharma y Exeltis. L.A.F. declara financiación a proyectos de investigación y honorarios de UCB Pharma, Esteve laboratorios, Eisai Inc., Angelini Pharma, BIAL Pharmaceutical, GW Pharmaceuticals, Neuraxpharm y Sanofi Genzyme. D.C.F. declara honorarios de Angelini Pharma y UCB Pharma. M.T.A. declara financiación de proyectos de investigación y honorarios de UCB Pharma, BIAL Pharmaceutical, Eisai Inc., Sanofi, Arvelle y Esteve Laboratorios. El resto de los autores no declara ningún conflicto de intereses.

                Article
                RN-77-215
                10.33588/rn.7709.2023146
                10831738
                37889129
                4369a798-4de4-4760-8402-3a6f232964ef
                Copyright: © Revista de Neurología

                Revista de Neurología trabaja bajo una licencia Creative Commons

                History
                : 17 October 2023
                Categories
                Original

                cápsulas audiovisuales,conocimientos,epilepsia,ensayo clínico aleatorizado,intervención educativa,monitorización vídeo-eeg,educational intervention,epilepsy,instructional clips,knowledge,randomized clinical trial,video-eeg monitoring

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