The Impact of Internet Hospital Follow-Up on the Quality of Life of Patients With Epilepsy: Randomized Controlled Trial.

BACKGROUND

As the second most common neurological disorder, epilepsy requires long-term management to ensure better seizure control and improved patient outcomes. Health education and sustained care significantly help people with epilepsy manage their condition effectively. Internet hospitals (IHs) have emerged as a promising approach to enhancing health care accessibility. These digital platforms can significantly improve the quality of life for patients with epilepsy. However, despite their growing adoption, research on the application of IHs in the follow-up management of epilepsy remains limited, highlighting the need for further investigation.

OBJECTIVE

This study has 2 primary aims. The first aim was to assess and compare the differences in quality of life, anxiety, and depression between IH follow-up and traditional outpatient follow-up for patients with epilepsy. The second aim was to explore chronic disease management models that are tailored to meet the needs of patients with epilepsy, improving their overall care.

METHODS

Eligible patients diagnosed with epilepsy were recruited at Sichuan Provincial People's Hospital and randomly assigned to the intervention or control group. Data collected included demographic information, clinical characteristics, and scores from the Quality of Life in Epilepsy-31 (QOLIE-31), Generalized Anxiety Disorder-7 Scale (GAD-7), and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). The control group received traditional outpatient follow-up, while the intervention group was managed via the IH. Both groups received epilepsy health education. After 6 months, changes in quality of life, anxiety, and depression were assessed using the same scales. Data analysis followed the intention-to-treat principle, and a linear mixed model was used to examine the intervention effect on primary and secondary outcomes. The effect sizes of group differences were calculated using Hedges g (0.2-0.4: small, 0.5-0.7: medium, and ≥0.8: large).

RESULTS

A total of 214 patients with epilepsy participated in the study (intervention group: N=107; control group: N=107). At the end of the study, 94.4% (101/107) in the intervention group and 93.5% (100/107) in the control group had completed the follow-up visits. After the intervention, the intention-to-treat analysis revealed evidence for improved quality of life (QOLIE-31 total score; F=13.10, P<.001) with small between-group effects (Hedges g=0.49, 95% CI 0.22-0.76) in favor of the intervention group. We also found evidence of reduced depression, as well as improved seizure worry, overall quality of life, emotional well-being, energy or fatigue, medication side effects, with effects ranging from small to medium (Hedges g=0.42-0.79).

CONCLUSIONS

Long-term follow-up through IHs can effectively improve the quality of life and reduce anxiety and depression in patients with epilepsy. This model provides effective support, making it an important tool for managing epilepsy. Therefore, IH management is recommended as a feasible approach for epilepsy follow-up in clinical practice.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2500101061; https://www.chictr.org.cn/showprojEN.html?proj=260855.