Antiepileptic drug adherence and persistence in children with epilepsy attending a large tertiary care children's hospital

Abstract

We aimed to evaluate antiepileptic drug treatment persistence and adherence in paediatric epilepsy patients and investigate the association between medication‐taking behaviours and clinical outcome. Methods. Medical and prescription records of newly treated paediatric epilepsy patients, aged 1–18 years who initiated antiepileptic drug monotherapy in a tertiary teaching hospital, were retrospectively reviewed. The rates of overall treatment, non‐persistence, a treatment gap >60 days, and adherence, as measured by a medication possession ratio ≥0.8, were assessed. The relationship between non‐adherence and clinical outcome, defined as an emergency department visit or hospitalisation due to seizure‐related reasons, was analysed. Results. A total of 1,172 patients met the inclusion criteria. The proportion of patients who were both persistent and adherent at one year was 70.14% and decreased to 56.83% at two years. Patients who started an antiepileptic drug at one year of age, took older generation antiepileptic drugs as the initial treatment, and those diagnosed with localized seizures were less likely to be adherent to and persistent with overall antiepileptic drug treatment. Patients who were non‐adherent to antiepileptic drug treatment were at an increased risk of hospitalisation or emergency department visits for seizure‐related reasons (adjusted HR 2.10, 95% CI 1.25–3.55). Conclusions. This large population study shows that 70% of paediatric epilepsy patients were persistent with and adherent to antiepileptic drugs after one year of treatment and confirms that non‐adherence to antiepileptic drug treatment is an important factor in seizure‐related clinical outcome.

Efficacy and safety of adjunctive perampanel in adolescent patients with epilepsy: Post hoc analysis of six randomized studies

“…Adherence to AEDs is important for preventing or minimizing seizures and is correlated with clinical outcome in patients with epilepsy [10]. However, adherence can be problematic, particularly in adolescent patients, since it is not unusual for patients in this age group to forget to take their AEDs or to self-initiate trials off medication [1,2,11,12].…”

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

“…Similar findings were reported in the Swedish study mentioned above (17), in which epilepsy and NeP had the best and worst persistence rates during follow-up. Generally speaking, studies evaluating drug treatment in epilepsy usually report high persistence or adherence rates (26)(27)(28). This could probably be attributed to the unremitting nature of most seizure disorders, as well as the devastating and potentially lifethreating consequences of not receiving treatment.…”

Refill Adherence Measures and Its Association with Economic, Clinical, and Humanistic Outcomes Among Pediatric Patients: A Systematic Review

“…The studies were conducted in 10 different countries, the majority (n = 33) of which were high-income countries, according to The World Bank definition [56]. These include the United States of America (n = 23) [21][22][23][24][25][26][27]29,[31][32][33][34][35]39,41,[47][48][49][50][51][52][53][54], United Kingdom (n = 3) [30,38,46], Israel (n = 2) [43,45], Taiwan (n = 1) [42], Korea (n = 1) [37], Australia (n = 1) [55], Netherlands (n = 1) [36], and Singapore (n = 1) [44]. Only two studies were conducted in upper-middle-income countries such as Brazil (n = 1) [28], and Malaysia (n = 1) [40].…”

“…Asthma (n = 9) was the most common disease state involved in the studies [24,25,28,30,31,[34][35][36]51], followed by human immunodeficiency virus (HIV) infection (n = 6) [21][22][23]47,49,50]. The sources of medication refill data were pharmacy records (n = 19) in approximately half of the studies, [21][22][23]28,33,35,37,40,44,[46][47][48][49][50][51][52][53][54][55], and administrative claims database (n = 16) in the remaining studies [24][25][26][27][29][30][31][32]34,36,38,39,[41][42][43]…”