Determinants of Compliance in Epileptic Outpatients

Bryant, Stephen G.; Ereshefsky, Larry

doi:10.1177/1060028081015007-808

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…Difficulty in taking the drug frequently is understandable and this could be a disadvantage for the full adherence 4 . However, our study cannot prove adherence to be a function of the amount or frequency of drug intake.…”

Section: Discussionmentioning

confidence: 99%

“…The items pool has been reduced by previous studies on adherence measures [3][4][5]8 that have given us clues for the most consistent items of medication-taking behavior and other attributes related to adherence. Pre-tests were done.…”

Section: Methodsmentioning

confidence: 99%

“…In the field of epilepsy, several papers raise the issues related to measurement of adherence and its determinants [3][4][5] . The basis for understanding why individuals do or do not adhere to medical recommendations is studied in behavioral models such as the health care belief model that is the most frequently used one to evaluate variables related to patient adherence 4 .…”

mentioning

confidence: 99%

“…The basis for understanding why individuals do or do not adhere to medical recommendations is studied in behavioral models such as the health care belief model that is the most frequently used one to evaluate variables related to patient adherence 4 .…”

mentioning

confidence: 99%

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Medication-taking behavior and drug self regulation in people with epilepsy

Gomes¹,

Filho²

1998

Arq. Neuro-Psiquiatr.

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-Objective: To study the most important characteristics of antiepileptic drug (AED) taking behavior in epileptic people. Methods: In a cross-sectional study, 45 consecutively seen patients answered a standardized questionnaire including questions about drug intake behavior. Results: Both genders were equally represented (22M x 23F). The mean age was 30.2 years. No specific characteristic were presented in all patients. The selfreported non-use of the drug at any moment one week before (self-reported non-adherence) was 40.0%. Patients took the drug more than once in most cases (75.0%), and the only precipitating factor of seizures more frequently avoided was alcohol intake (66.7%). Forty-four percent said to be afraid of becoming addicted to the medicine, 61.4% reduced or stopped the medicine just to see what would happen, and 47.7% changed the prescription with the same purpose. There is no relationship among socio-demographic, behavior aspects or treatment characteristics, and self-reported non-adherence. Conclusions: Several patient's aspects do not seem to be strongly correlated with self-reported adherence. Nevertheless, drug self-regulation is probably related to the drug-intake behavior, and it is important for the physician to understand this parallel influence on treatment for a more realistic approach.KEY WORDS: epilepsy, adherence, antiepileptic drug. Comportamento de auto regulação da ingesta de medicamentos em pessoas com epilepsiaRESUMO -Objetivo: Estudar as mais importantes características do comportamento de ingesta das drogas antiepilépticas (DAE) em pessoas com epilepsia. Método: Em estudo transversal, 45 pacientes consecutivamente vistos responderam a questionário padronizado sobre o comportamento de ingesta de DAE. Resultados: Ambos os sexos foram igualmente representados. A idade média foi 30,2 anos. Não há uma característica específica comum em todos os pacientes. O auto-referido não uso da DAE na semana anterior, em qualquer momento, (auto-referida não-aderência) foi de 40,0%. Pacientes ingeriram a droga mais de uma vez, em muitos casos (75,0%) e o único fator precipitante de crises epilépticas mais frequentemente evitado foi a ingesta de álcool (66,7%). Quarenta e quatro por cento se diziam preocupados em se tornarem dependentes do medicamento, 61,4% reduziram ou suspenderam a DAE apenas para ver o que acontecia e 47,7% mudaram as prescrições com o mesmo propósito. Não houve relação entre características sócio-demográficas, aspectos comportamentais ou características de tratamento, e auto-referida não aderência. Conclusões: Vários aspectos dos pacientes não parecem estar relacionados fortemente com a aderência auto-referida. No entanto, a auto regulação da ingesta de drogas é provavelmente relacionada ao comportamento íntimo de sua ingesta, e é importante para o médico entender essa influência paralela no tratamento para uma abordagem mais realística. PALAVRAS-CHAVE: epilepsia, aderência, droga antiepiléptica.Low adherence to prescribed medication by the physician is considered th...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Medication-taking behavior and drug self regulation in people with epilepsy

Gomes¹,

Filho²

1998

Arq. Neuro-Psiquiatr.

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“…Consequently, drug intake adherence is a fundamental process in effective therapy, and in clinical practice its measurement has to be done frequently to apply adherence-improving interventions [1][2][3][4][5][6][7][8] .…”

Section: Aderência à Ingestão De Medicamentos Antiepilépticos: O Valomentioning

confidence: 99%

Anti-epileptic drug intake adherence: the value of the blood drug level measurement and the clinical approach

Gomes

Filho

Noé

1998

Arq. Neuro-Psiquiatr.

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-It was evaluated the patient antiepileptic drug (AED) intake adherence in a pilot cross-sectional study carried out at a neurologic out-patient clinic of a university hospital. Ninety-three AED blood concentration (phenobarbital, phenytoin, carbamazepine) were analyzed from 24 patients. The variability of the AED blood level was measured (in the steady state period by means of the variation coefficient) and compared with the selfreported antiepileptic medication non-adherence, AED blood level according to the range (therapeutic or not), and the seizure control. It was not observed any strong correlation between the higher value of variability and the other three parameters of no adherence. The highest correlation was with the blood drug level (therapeutic or not). The evaluation of blood drug measurement alone, except in cases of extreme low adherence and variability of drug intake, is not enough for the recognition of incorrect drug intake, but the clinical markers and the selfreported adherence have to be also considered for this sort of evaluation.KEY WORDS: epilepsy, adherence, therapeutic blood monitoring, antiepileptic drugs. Aderência à ingestão de medicamentos antiepilépticos: o valor da avaliação dos níveis sanguíneos e a abordagem clínicaRESUMO -Avaliou-se a aderência à ingesta de drogas antiepilépticas (DAE) em estudo piloto transversal conduzido em ambulatório de hospital neurológico universitário. Noventa e três amostras sanguíneas com concentração de DAE (fenobarbital, fenitoína, carbamazepina) foram analisadas de 24 pacientes. A variabilidade dos níveis sanguíneos das DAE (em estado estável -steady state period, analizada por meio do coeficiente de variação) foi comparada com a auto-referida não aderência à ingesta da DAE, níveis sanguíneos das DAE de acordo com a faixa (terapêutica ou não) e o controle das crises epilépticas. Não foi observada correlação forte entre o maior valor da variabilidade e os outros três parâmetros de aderência, apesar da maior correlação com o nível sanguíneo (terapêutico ou não). A avaliação do nível sérico isolado, exceto em caso de extrema baixa aderência e variabilidade da ingesta das DAE, não é suficiente para o reconhecimento da ingesta inadequada, mas os marcadores clínicos e a auto-aderência referida também têm que ser consideradas para esse tipo de avaliação.PALAVRAS-CHAVE: epilepsia, aderência, monitorização de níveis sanguíneos, drogas antiepilépticas.Poor adherence is considered the most important cause for unsuccessful treatment in epilepsy. Consequently, drug intake adherence is a fundamental process in effective therapy, and in clinical practice its measurement has to be done frequently to apply adherence-improving interventions [1][2][3][4][5][6][7][8] .

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Epilepsy Self-Management

Iorio

1997

Handbook of Health Behavior Research II

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Determinants of Compliance in Epileptic Outpatients

Cited by 14 publications

References 11 publications

Medication-taking behavior and drug self regulation in people with epilepsy

Medication-taking behavior and drug self regulation in people with epilepsy

Anti-epileptic drug intake adherence: the value of the blood drug level measurement and the clinical approach

Epilepsy Self-Management

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