{"doi":"10.1016/j.yebeh.2025.110495","title":"Self-management for people with epilepsy and a history of negative health events (SMART): A randomized controlled effectiveness trial","abstract":"OBJECTIVES: This 2-site, 6-month randomized controlled trial of an epilepsy self-management (ESM) curriculum (SMART) vs. 6-month waitlist (WL) control assessed effects on epilepsy outcomes in 160 people with epilepsy (PWE). METHODS: PWE had at least 1 negative health event (NHE) defined as a seizure, emergency department visit, hospitalization or self-harm attempt in the last 6 months. Primary outcomes were differences in proportions of PWE with reductions in NHEs from baseline to 6 months follow up and change in NHE/seizure counts between SMART and WL. Secondary outcomes included the Patient Health Questionnaire (PHQ-9), 36-Item Short Form Survey (SF-36), Quality of Life in Epilepsy (QOLIE-31), Epilepsy Self-Management Scale (ESMS), Epilepsy Stigma Scale (ESS), Multidimensional Scale of Perceived Social Support (MSPSS) and Epilepsy Self-Efficacy Scale (ESES). RESULTS: Mean age was 39.4 (SD 12.2), 66.9 % (N = 107) women, and 31 % (N = 50) rural. Mean PHQ-9 of 10.5 (SD 7) suggested mild/moderate depression. Seizures were the most common NHE with mean baseline past 6-month seizure count of 20.6 (SD 41.0). SMART was significantly associated with a 2-fold increase in odds of having at least 10-30 % improvement in NHEs vs. WL (p < 0.05). SMART was associated with significant seizure reduction (p < 0.05), significantly improved PHQ-9 (p = 0.014), QOLIE-31 seizure worry (p = <0.001) and social functioning (p = 0.021), ESES (p = 0.046) and ESMS (p < 0.001). SIGNIFICANCE: Compared to WL, SMART participants had improvement in NHEs and seizures, depressive symptoms, self-management competency and self-efficacy and selected elements of quality of life. Inclusion of effective ESMs into a comprehensive care of model for PWE may be warranted.","journal":"Epilepsy & Behavior","year":2025,"id":515123,"datarank":0.29188652235829704,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.0,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9518,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":736175,"name":"Gena R. Ghearing","orcid":"0000-0002-4477-2868","position":1,"is_corresponding":false},{"id":1254210,"name":"Maegan Tyrrell","orcid":null,"position":2,"is_corresponding":false},{"id":1254211,"name":"Jessica Black","orcid":null,"position":3,"is_corresponding":false},{"id":1254212,"name":"Jacqueline Krehel-Montgomery","orcid":null,"position":4,"is_corresponding":false},{"id":1254214,"name":"Richard Barigye","orcid":null,"position":5,"is_corresponding":false},{"id":890089,"name":"Joy Yala","orcid":null,"position":6,"is_corresponding":false},{"id":1254215,"name":"Clara Adeniyi","orcid":null,"position":7,"is_corresponding":false},{"id":710286,"name":"Michael Privitera","orcid":"0000-0002-0862-5975","position":8,"is_corresponding":false},{"id":448978,"name":"Marvin A. Rossi","orcid":"0000-0003-4608-3916","position":9,"is_corresponding":false},{"id":340297,"name":"Farren Briggs","orcid":"0000-0003-0903-1359","position":10,"is_corresponding":false},{"id":315573,"name":"Martha Sajatovic","orcid":"0000-0002-3073-668X","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:48:34.431522Z","pmid":"40412342","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}