HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) was developed to help people with epilepsy overcome their memory problems to lead happier, more productive lives. It is an 8-session intervention incorporating (1) psychoeducation, (2) self-awareness training, (3) compensatory strategies, and (4) application of these strategies in day-to-day life using problem solving therapy. Trained "Memory Coaches" deliver the intervention primarily by telephone to forgo transportation barriers. A previous trail demonstrated efficacy in improving quality of life and objective cognition, and this subsequent trial was design to evaluate dissemination and fidelity in other epilepsy centers.

To expand implementation and replicate results of HOBSCOTCH—an innovative telephone based self-management program addressing memory problems in epilepsy.

A pragmatic replication trial was conducted at four epilepsy centers in four New England states. This multi-year, multi-site study included training HOBSCOTCH Memory coaches at all sites, and providing technical assistance and coaching. Each site was responsible for recruitment, enrollment, and HOBSCOTCH delivery. Adults with epilepsy, age 18-70 (n=84) received either the HOBSCOTCH intervention (n=36) or were assigned to waitlisted control (n=48). This analysis includes baseline and 3-month time points for the primary outcome measure of quality of life (Quality of Life in Epilepsy scale, QOLIE-31) and secondary outcome measures of depression (Patient Health Questionnaire, PHQ-9) and subjective cognition (Neuro-QOL-Cognitive Function).

The HOBSCOTCH intervention group (n=36), showed significant improvement in overall quality of life score (p<.001) and in five specific quality of life domains as compared to waitlist controls. There were significant improvements in self-rated cognition as compared to waitlisted controls (p=.01). There were no significant changes in depression (p=0.17).

The HOBSCOTCH program improves quality of life and self-reported cognition. It can be implemented in multiple epilepsy centers while maintaining fidelity and replicating primary outcomes.