Adherence to Antiepileptic Therapy in Adults

Abstract

Context:Epilepsy is a neurological disorder affecting 70 million worldwide. The high incidence of relapse can be attributed to nonadherence, thus increasing the incidence of refractory epilepsy to 10%–20%.Aims:This study was planned to determine rate of adherence and factors affecting adherence using Antiepileptic Adherence Questionnaire and Baseline Adherence Questionnaire.Materials and Methods:A cross-sectional, questionnaire-based study was carried out at a rural hospital from May to September 2015. Patients of either gender aged 18–60 years, diagnosed with epilepsy were interviewed after they consented. Patient details, responses to questionnaires were collected and analyzed using descriptive statistics.Results:Among the participants, 67.8% were males and 32.2% were females with the mean age of 38.3 ± 13.9 years. The response rate was 75% (90/120). The majority were literate (64.4%) and employed (58.9%). The duration of disease was <5 years in most individuals; 50% were highly, 21.1% moderately, and 28.9% nonadherent to treatment. Among the highly adherent, 66.7% never skipped medications because they had knowledge of the disease and treatment. More than 97% were satisfied with the social support, and 89% expressed that their family and friends reminded them to take medications. Patients who were nonadherent to treatment attributed it to the lack of knowledge of the disease (57%) and treatment (96%). Reasons for nonadherence were patients assumed drug was harmful, felt cured of the disease, and wanted to avoid side effects.Conclusion:Nearly, 70% expressed the lack of satisfactory support from the social circle. We observed that nearly seventy percent epileptic patients were moderate-highly adherent. Nonadherence was attributed to patient feeling cured of disease and assuming medications to be harmful. Counseling of patients will help in adherence to treatment.

Factors limiting adherence to antiepileptic treatment: A French online patient survey

“…Medication non‐adherence is widespread, varying according to chronic disease, and medication non‐adherence is considered a major problem in medical practice There is no consensus on what constitutes adequate adherence in patients with epilepsy but with 79% of patients reported to be adherent to their medication. Our results are similar to those of previous studies conducted among patients with epilepsy on AED . In our study and as previously described, adherence was not correlated with higher seizure frequency .…”

“…Previous studies on AED adherence reported adherence rates ranging from 36% to 71% . It is therefore crucial to analyze adherence, which needs to be examined from the patients “point of view.” Adherence is a dynamic phenomenon, and psychosocial factors and lifestyle can have an influence . Accurate assessment of adherence behaviour is necessary for effective and efficient treatment planning …”

Predictors of nonadherence in children and adolescents with epilepsy: A multimethod assessment approach

“…Reports on the extent of non-adherence to (AEDs) in patients with epilepsy vary considerably, ranging from 3.5% to 68% in children [3,[6][7] and from 28.9-74.8% in adults [8][9][10][11] depending on the population studied and method used to assess adherence.…”

Prevalência e fatores associados à presença de medicamentos vencidos em estoques caseiros

“…A prevalência de medicamentos vencidos foi elevada, visto que 45,4% das residências apresentavam pelo menos um medicamento vencido (Tabela 1). A proporção total de medicamentos vencidos encontrada no presente estudo foi de 10,3%, variando de 0% a 75%, com média de 9,4 (DP = 13,9).…”

“…Assim sendo, a ampliação do acesso não garante o uso correto e racional do medicamento. Neste sentido, é importante destacar que a não adesão ao tratamento farmacológico é um dos principais problemas farmacoterapêuticos existentes no Brasil e em outros países [6][7][8] , gerando consequências clínicas, humanísticas e econômicas que oneram o sistema de saúde de forma desnecessária, exemplificado pelo acúmulo e pelo vencimento de medicamentos nos domicílios 6,9 .…”