Jakość życia pacjentów z epilepsją w warunkach trudności społeczno-gospodarczych w Libanie
Quality of life in patients with epilepsy in the context of socioeconomic challenges in Lebanon
W skrócie
Badanie wykazało, że dorośli pacjenci z epilepsją w Libanie mają poważnie obniżoną jakość życia, szczególnie z powodu skutków ubocznych leków przeciwpadaczkowych, bezrobocia i trudności w dostępie do leków. Naukowcy przebadali 578 pacjentów i odkryli, że najważniejszym czynnikiem wpływającym na pogorszenie jakości życia są działania niepożądane leków, a znaczenie mają też bezrobocie, ubóstwo i poziom wiedzy pacjentów o zdrowiu. Autorzy zaproponowali kompleksowe podejście do leczenia, które powinno skupiać się nie tylko na samych lekach, ale także na wsparciu społecznym i edukacji pacjentów.
Oryginalny abstract (angielski)
PURPOSE: Epilepsy significantly impairs health-related quality of life (HRQoL), yet evidence from Lebanon; a country experiencing one of the most severe economic crises since the mid-nineteenth century, remains limited. This study examined multidimensional quality of life (QoL) among adults with epilepsy in Lebanon and identified its clinical, socioeconomic, and crisis-related determinants. METHODS: A multicenter cross-sectional study was conducted between June and October 2025, recruiting 578 adults with confirmed epilepsy from community pharmacies and neurology outpatient clinics across all Lebanese governorates. Three validated instruments were administered: the Quality of Life in Epilepsy Inventory-10 (QOLIE-10), the EuroQol Five-Dimension Five-Level (EQ-5D-5 L), and the ICEpop CAPability measure for Adults (ICECAP-A). Bivariate analyses and multivariable linear regression models (Enter method) identified independent determinants of each QoL outcome. RESULTS: Mean scores indicated meaningful impairment across all domains (QOLIE-10: 2.39 ± 0.78; EQ-5D-5 L utility index: 0.79 ± 0.24; ICECAP-A: 0.81 ± 0.21). Nearly half of participants were unemployed (48.3%) and faced antiseizure medication (ASM) shortages (50.5%). Adverse ASM effects had the largest independent effect on QoL across all three instruments (standardized β = 0.25-0.42), representing a small-to-moderate effect and exceeding all other predictors. Poorer medication adherence showed smaller but consistent independent effects on worse outcomes in the QOLIE-10 and ICECAP-A models (β = 0.08-0.12, negligible-to-small), while greater household crowding was independently associated with worse QOLIE-10 scores only (β = 0.08, negligible). Higher health literacy showed small independent effects on better QoL across all three instruments (β = 0.16-0.19). CONCLUSION: Adults with epilepsy in Lebanon experience substantial QoL impairment across epilepsy-specific, generic, and capability-based domains, associated with treatment burden, socioeconomic vulnerability, and crisis-related barriers to care. Integrated strategies addressing medication tolerability, adherence, health literacy, and structural determinants of health are needed to improve outcomes in this population.