To assess the longitudinal effects of the HOBSCOTCH epilepsy self-management program.

HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) is a behavioral intervention addressing cognitive dysfunction in adults with epilepsy. It has previously demonstrated efficacy in improving quality of life (QOL) and objective cognition. The current study presents longitudinal data from the multi-site, pragmatic replication trial.

This analysis focused on HOB-IP results. Differences between the in-person and virtual groups are discussed in another abstract.  HOB-IP showed significant improvements in QOL compared to controls (p<0.001) immediately post-intervention. Objective cognition remained unchanged, but self-reported cognitive function was improved following the intervention (p<0.001). At 3 months post-HOBSCOTCH, overall QOL scores dropped from a 12.4 point treatment effect to a 5.2 point effect, which was not statistically significant compared to controls (p=0.1). NeuroQOL scores dropped from a 6.2 treatment effect to a 2.4 point effect (p=0.13).

A within-group analysis tracked outcomes out to 6 months post-intervention. Statistically significant improvements were seen in both QOL (p=0.002) and subjective cognition (p<0.001) post-HOBSCOTCH compared to baseline. By 3 months post-treatment, subjective cognition scores were still improved (p=0.012), but overall QOL was not. At 6 months post, both outcome measures lost significance but remained elevated from baseline and appeared to stabilize.  

This is the first study to evaluate the longitudinal effects of HOBSCOTCH. While the intervention conveys significant short-term benefits, the effects diminished over time, suggesting that self-directed use of HOBSCOTCH was uncommon. Because the biggest drop in overall QOL occurred 3 months post-treatment, booster sessions may help sustain benefits.