Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy

Moura, Lidia M.V.R.; Carneiro, Thiago; Cole, Andrew J.; Hsu, John; Vickrey, Barbara G.; Hoch, Daniel B.

doi:10.2147/ppa.s119973

Cited by 16 publications

(6 citation statements)

References 65 publications

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“…Patients were also more encouraged to ask about their medications and to get more information about adverse effects. 24 Results of this study were also consistent with those reported by Moura et al 25 who evaluated the effect of education about AEDs adverse effects on adherence and concluded that, despite knowledge about the possible adverse effects of AEDs, it did not affect their reported adherence to medications.…”

Section: Discussionsupporting

confidence: 89%

The Role of Clinical Pharmacist in Pediatrics’ Adherence to Antiepileptic Drugs

Jarad

Akour

Khreisat

et al. 2022

Journal of Pharmacy Technology

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Background: Rate of nonadherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment. Objectives: To investigate the effect of a clinical pharmacist-led education on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL). Methods: This was an interventional study where pediatric patients were randomly assigned to the intervention (n = 41) or the control (n = 40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the first group as add-on to standard medical care received by latter. Outcomes were measured at baseline and after 8-week follow-up. Results: The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow-up ( P value < 0.001), while the control group had no significant change ( P value > 0.05), the difference between the 2 groups at follow-up was significant ( P value < 0.0001). No significant difference was observed between groups at follow-up with regard to effectiveness ( P value > 0.05), and safety ( P value = 0.08). While higher satisfaction with information ( P value < 0.0001), and higher QoL ( P value < 0.05) was observed in the intervention group. Conclusion and relevance: Clinical pharmacist-led education had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.

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Section: Discussionsupporting

confidence: 89%

The Role of Clinical Pharmacist in Pediatrics’ Adherence to Antiepileptic Drugs

Jarad

Akour

Khreisat

et al. 2022

Journal of Pharmacy Technology

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“…Based on previous studies [10,30,34], each item is coded 0 if the answer is "Yes" and 1 if "No". A score can range from 0 to 4.…”

Section: Definition Of Dependent Variablesmentioning

confidence: 99%

Self-reported attitudes about medication in Lebanese people with epilepsy

Mroueh

Boumédiène

Jost³

et al. 2019

Epilepsy & Behavior

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Background: Epilepsy is a common worldwide neurological disorder. For people with epilepsy, adherence and attitudes towards medication is a crucial step to improve efficacy of prescribed treatment and to prevent seizures.Objectives: The first aim of this study was to evaluate attitudes towards antiepileptic medications in Lebanese population. Secondary aims were to assess factors affecting attitudes and associated with epilepsy control.Material and Methods: A cross-sectional study was conducted in out-patients neurology clinics located in Beirut-Lebanon. Data was collected using a structured questionnaire. Self-report of medication taking behaviors were assessed using the abbreviated (4-items) Morisky Medication Adherence Scale (MMAS-4). Epilepsy was considered as controlled if the patient had no seizures in the last 6 months.Results: Among 250 people with epilepsy (PWE) recruited in this study, male-to-female ratio was 0.87 (116/134), and 50.8% were married. Mean duration of epilepsy was 13.7 ± 12.8 years. Valproate was the most common antiepileptic drug used followed by levetiracetam and carbamazepine. About 60.8% of the population presented partial epilepsy. Uncontrolled epilepsy was present in more than half of participants (55.2%), with only 32.4% had positive attitudes to their medication. Positive attitudes towards antiepileptic increased in people who found their treatment was efficacious (OR=4.9; 95%CI 1.2-20.0; p=0.03), who had controlled epilepsy (OR=3.4; 95%CI 1.6-7.1; p=0.001), and who were diagnosed as people with epilepsy between the age of 12-20 years (OR=3.1; 95%CI 1.1-8.4; p=0.03). Oppositely, these attitudes decreased in participants who felt their treatment as an economic burden (OR=0.2; 95%CI 0.1-0.4; p<0.001), and in depressive people (OR=0.4; 95%CI 0.2-0.9; p=0.04). Controlled epilepsy was higher in people who contacted a neurologist if seizure occurred, in people with positive attitudes, and after a long duration of disease, but it decreased if patient didn't follow neurologist's instructions in fasting period.Conclusions: Lebanese PWE were less likely to have positive attitudes towards medication, which may lead to poor epilepsy control. Depression and economic burden were the major factors decreased these attitudes. Identifying factors affecting attitudes to medication and leading to controlled epilepsy may help clinicians to elaborate educational programs to optimize medication adherence.

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“…Most of the anti-epileptic drugs have a lot of untoward effects which sometimes force the patients to stop these on their own or skip the doses. It is understandable and also reported in the literature by Moura et al, that using multiple medications for control of seizures in an epileptic patient result in non-adherence and management strategy of combining the AEDs eventually becomes counter theraputic 19,20 . This association was supported by our study analysis and polypharmacy emerged as strong predictor of non-compliance among the epileptic patients.…”

Section: Discussionmentioning

confidence: 94%

“…Studies by Getnet et al, and Moura et al, in 2016 in have also produced similar results. Longer duration of illness whether treated or untreated can have direct and indirect effects on the body which can give rise to various problems including the compliance 9,20 .…”

Section: Discussionmentioning

confidence: 99%

Frequency and Factors of Non-Compliance Among Epileptic Patients

Gilani

Nawaz

Hassan

et al. 2021

PAFMJ

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Objective: To determine the frequency of non-compliance among the patients of epilepsy and factors related to the presence of non-compliance at a tertiary care hospital of Pakistan. Study Design: Cross-sectional analytical study. Place and Duration of Study: Neurology department, Pak Emirates Military Hospital Rawalpindi, form Dec 2018 to Jun 2019. Methodology: A total of 133 cases were included in the study, which were diagnosed as epilepsy for more than 6 months by a consultant neurologist. Medication and drug adherence was assessed by validated Urdu version of our-item Morisky Medication Adherence Scale. Relationship of age, gender, socio-economic class, duration of epilepsy, education, marital status and poly-pharmacy was assessed with the presence of non-compliance among the patients suffering from epilepsy. Results: There were 53 (39.9%) patients were females while 80 (60.1%) were males. Out of 118 patients of epilepsy, 59 (44.4%) showed the presence of non-compliance while 74 (55.6%) had good compliance. After applying the logistic regression we found that duration of illness and poly-pharmacy had significant association with the presence of non-compliance among the patients of epilepsy. Conclusion: Non-compliance emerged as a highly prevalent behavior or clinical condition among the patients of epilepsy in our target population. Before combining the pharmacological agents it is advisable to check the compliance of already prescribed drugs used to control the seizures. Patients with long standing illness or those who are put on multiple medications should be regularly screened for non-adherence.

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Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy

Cited by 16 publications

References 65 publications

The Role of Clinical Pharmacist in Pediatrics’ Adherence to Antiepileptic Drugs

The Role of Clinical Pharmacist in Pediatrics’ Adherence to Antiepileptic Drugs

Self-reported attitudes about medication in Lebanese people with epilepsy

Frequency and Factors of Non-Compliance Among Epileptic Patients

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