Socioeconomic status and self-management in epilepsy: Comparison of diverse clinical populations in Houston, Texas

We compared the scores on self-management and associated psychosocial scales of patients with epilepsy at two clinics in Houston, TX, USA, to determine if there were systematic differences associated with socioeconomic status (SES). Patients of low SES reported higher scores on overall, information, and safety management (P < 0.03) and no differences on medication, seizure, and lifestyle management. The two groups were similar with respect to the pattern of high and low scores. Reported levels of self-efficacy, depression, social support, stigma, desire for control, and outcome expectations were higher for those of high SES (P < 0.01). Knowledge of epilepsy and satisfaction with care were lower (P < 0.01). Again, the patterns of high and low scores were similar. Tests of association between psychosocial factors and self-management revealed that people with higher levels of self-efficacy and social support also reported higher self-management (P < 0.01) regardless of demographics, seizure frequency, and SES (P < 0.05). These findings provide little support for SES-related disparities in self-management and suggest that the focus of strategies to improve self-management may be similar across diverse populations.

Research Highlights
► We compared the self-management behavior and associated psychosocial scores of socio-economically diverse patient populations selected from two epilepsy clinics in Houston, Texas.
► The average scores on self-management were slightly higher for the low-socio-economic status (SES) patients compared to the high-SES patients and the psychosocial scores were different. However, the differences were small and the high/low patterns were similar.
► Self-efficacy and social support were strongly associated with self-management behavior in both patient groups (p < .01), suggesting that similar strategies to improve self-management may be applicable across diverse populations.