Behavioral predictors of medication adherence trajectories among youth with newly diagnosed epilepsy

Loiselle, Kristin A.; Rausch, Joseph R.; Modi, Avani C.

doi:10.1016/j.yebeh.2015.06.040

Cited by 42 publications

(39 citation statements)

References 48 publications

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“…We did not gather information about the adequacy of the prescribed antiseizure drug treatments. Patients taking medication more frequently are less likely to be adherent compared to patients taking extended-release or once a day formulations 36,55,67. This and many other factors, from tablet color to treatment affordability, may have had an impact in the adherence that has yet to be measured.…”

Section: Discussionmentioning

confidence: 99%

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

Moura¹,

Carneiro²,

Cole³

et al. 2016

PPA

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Background and aimAdherence to treatment is a critical component of epilepsy management. This study examines whether addressing antiepileptic drug (AED) side effects at every visit is associated with increased patient-reported medication adherence.Patients and methodsThis study identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits over a 3-year period. Demographic and clinical characteristics were abstracted. Evidence that AED side effects were addressed was measured through 1) phone interview (patient-reported) and 2) medical records abstraction (physician-documented). Medication adherence was assessed using the validated Morisky Medication Adherence Scale-4. Complete adherence was determined as answering “no” to all questions.ResultsSixty-two (25%) patients completed the interviews. Participants and nonparticipants were comparable with respect to demographic and clinical characteristics; however, a smaller proportion of participants had a history of drug-resistant epilepsy than nonparticipants (17.7% vs 30.9%, P=0.04). Among the participants, evidence that AED side effects were addressed was present in 48 (77%) medical records and reported by 51 (82%) patients. Twenty-eight (45%) patients reported complete medication adherence. The most common reason for incomplete adherence was missed medication due to forgetfulness (n=31, 91%). There was no association between addressing AED side effects (neither physician-documented nor patient-reported) and complete medication adherence (P=0.22 and 0.20).Discussion and conclusionAmong patients with epilepsy, addressing medication side effects at every visit does not appear to increase patient-reported medication adherence.

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Section: Discussionmentioning

confidence: 99%

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

Moura¹,

Carneiro²,

Cole³

et al. 2016

PPA

View full text Add to dashboard Cite

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“…Generally there are several factors that can influence medication adherence to AEDs in adolescents including regimen complexity or their beliefs about medication as they may stop taking the medication because they do not want to be viewed as being different than others [12]. Research on children population has revealed that disliking the taste of medication, running out of medications [13], parent forgetfulness, refusal to take medications [13,14], difficulties in swallowing the medication [14], lower socioeconomic status [15][16][17] and family conflict and difficulties in communication particularly during adolescence [17] were barriers to adherence to AEDS. Poor adherence to prescribed AEDs is associated with negative consequences such as reduced seizure control [18][19][20], higher incidence of hospital admissions [20][21][22] and increased health care costs [5,23,24].…”

Section: Introductionmentioning

confidence: 99%

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

Alsous

Hamdan

Saleh

et al. 2018

Epilepsy & Behavior

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The use of a multimethod approach for assessing adherence increases sensitivity for detection of nonadherence to AEDs. Disease duration and parental necessity beliefs and concerns assessed by the BMQ-specific questionnaire were significant predictors of nonadherence to the AED therapy. The need for the development and implementation of interventions that can be employed to improve adherence within this pediatric population has been highlighted by the high levels of nonadherence identified.

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“…Acceptability of/participation in the recommended treatment regime. Psychosocial factors are associated with medication non-adherence, for example, following acute coronary syndrome [51], in haemodialysis patients [52], in youth with newly diagnosed epilepsy [53]. One systematic review of study of psychosocial factors predicting non-adherence to preventative maintenance medication therapy produced a negative result and call for more research [54].…”

Section: Emerging Evidence Of Psychosocial Causationmentioning

confidence: 99%

The Biopsychosocial Model 40 Years On

Bolton

Gillett

2019

The Biopsychosocial Model of Health and Disease

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The first chapter outlines George Engel's proposal of a new biopsychosocial model for medicine and healthcare in papers 40 years ago and reviews its current status. The model is popular and much invoked in clinical and health education settings and has claim to be the overarching framework for contemporary healthcare. On the other hand, the model has been increasingly criticised for being vague, useless, and even incoherent-clinically, scientifically and philosophically. The combination of these two points signifies something of a crisis in the conceptual foundations of medicine and healthcare. We outline some of the emerging evidence implicating psychosocial as well as biological factors in health and disease, and propose the following solution to the vagueness problem: that the scientific and clinical content of the model relates to specific conditions and stages of conditions, so that there is, for example, a biopsychosocial model of cardiovascular disease, diabetes or depression. Much the same point applies to the narrower biomedical model. However this raises the question: what is the point of having a general model? Our response is that it is needed to theorise biopsychosocial interactions in health and disease. In the light of historical prejudices against psychosocial causation deriving from physicalist reductionism and dualism, recognised by Engel and current commentators on the biopsychosocial model, this is a non-trivial task that occupies subsequent chapters. Engel's Proposed Improvement on the Biomedical ModelIn his classic paper published in 1977 George Engel proposed a new model for medicine, the biopsychosocial model, contrasted with the existing biomedical model [1]. While recognising the great advances in biomedicine, Engel argued that nevertheless the biomedical model was limited, and insufficient for many aspects of medical science and healthcare. These limitations were extensive, comprising failure to take account of the following: the person who has the illness, the person's experience of, account of and attitude towards the illness; whether the person or others in fact regard the condition as an illness; care of the patient as a person; for some conditions such as schizophrenia and diabetes, the effect of conditions of living on onset, presentation and course; and finally, the healthcare system itself also cannot be conceptualised solely in biomedical terms but rather involves social factors such as professionalisation ([1], pp. 131-135). Engel argued that a broadening of the biomedical approach, a new biopsychosocial model, was needed to take account of all these factors 'contributing to both illness and patienthood' ([1], p. 133). The Presumed 'Overarching Framework'In his review of a recent book on the biopsychosocial model by Nassir Ghaemi [2], in The American Journal of Psychiatry, Kenneth Kendler starts with the sentence: "This book is about a very important topicthe overarching conceptual framework of our field of psychiatry" ([3], p. 999).Whether the biopsychosocial model has this s...

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Behavioral predictors of medication adherence trajectories among youth with newly diagnosed epilepsy

Cited by 42 publications

References 48 publications

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

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

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

The Biopsychosocial Model 40 Years On

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