Postictal serum levels of antiepileptic drugs for detection of noncompliance

Specht, Ulrich; Elsner, Heike; May, Theodor W.; Schimichowski, B; Thorbecke, Rupprecht

doi:10.1016/s1525-5050(03)00151-3

Cited by 57 publications

(33 citation statements)

References 36 publications

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“…[24] A study in Germany measured postictal serum levels of antiepileptic medications and confirmed that in at least 44% of cases the seizure was related to poor compliance. [29]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Molugulu¹,

Gubbiyappa²,

Murthy³

et al. 2016

J Basic Clin Pharma

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Introduction:Reports on medication adherence and its associated factors in patients with epilepsy in South East Asian countries are lacking. The primary purpose of this study was to assess the degree of medication adherence and its relationship with patient's satisfaction, psychosocial factors, quality of life and mental health in a sample of Malaysian epilepsy patients.Methodology:It is a cross-sectional study and was carried out in the outpatient Neurology Department of Hospital Kuala Lumpur, Malaysia (n=272). Data was collected by administering the structured questionnaire.Results and Discussion:Results showed that 49.3% of the epilepsy patients were non-adherent to their prescribed regimen. Univariate analysis showed significant associations between medication adherence and the following factors: race, seizure frequency, overall patient satisfaction, medication taste and smell, medication cost and physical appearance, medication effectiveness, complexity of medication regimen, patient barrier, patient understanding, patient role functioning, patient positivity, vitality and general interest. Multiple regression analysis indicated that factors that are influencing medication adherence are seizure frequency (P = 0.048), overall patient satisfaction (P = 0.043) and patient understanding about their illness (P = 0.001). The model chosen for testing the relationship between medication adherence and its associated factors give an R2 value of 25.2% with an adjusted R2 of 21.4%. The F value was also significant (P = 0.000). Based on the research findings, the researchers recommends that clinicians need to play a vital role in educating the patients on their disease conditions. By educating the patients on nature of epilepsy, different modalities of treatment and benefits of adherence to treatment will help in the better adherence and management.

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“…[24] A study in Germany measured postictal serum levels of antiepileptic medications and confirmed that in at least 44% of cases the seizure was related to poor compliance. [29]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Molugulu¹,

Gubbiyappa²,

Murthy³

et al. 2016

J Basic Clin Pharma

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“…This may explain the differences in therapeutic drug levels from our study compared to other studies. [25–27]. …”

Section: Discussionmentioning

confidence: 99%

Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting

Nazziwa¹,

Mwesige²,

Obua³

et al. 2014

Pan Afr Med J

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IntroductionEpilepsy is one of the neglected and highly stigmatised diseases, yet it is very common affecting about 70 million people worldwide. In Uganda, the estimated prevalence of epilepsy is 13% with about 156 new cases per 100,000 people per year. Adherence to antiepileptic drugs is crucial in achieving seizure control yet in Uganda; there is lack of information on adherence to antiepileptic drugs and the factors that affect this among children. This study was therefore designed to determine the level of adherence to antiepileptic drugs and the factors that are associated with non adherence.MethodsIn a cross sectional study, 122 children who met the inclusion criteria were enrolled and interviewed using a pretested questionnaire. Assessment of adherence to antiepileptic drugs was done by self report and assay of serum drug levels of the antiepileptic drugs. Focus group discussions were held to further evaluate the factors that affect adherence.ResultsAge range was 6 months - 16 years, male to female ratio 1.3:1 and majority had generalised seizures 76 (62.3%). Adherence to antiepileptic drugs by self report was 79.5% and 22.1% by drug levels. Majority of the children in both adherent and non adherent groups by self report had inadequate drug doses (95/122). Children were found to be more non-adherent if the caregiver had an occupation (p-value 0.030, 95%CI 1.18-28.78)ConclusionMajority of children had good adherence levels when estimated by self report. The caregiver having an occupation was found to increase the likelihood of non adherence in a child.

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“…However, pill count may not be accurate in estimating adherence; it tends to overestimate medication adherence and yield an imprecise metric of the total dose taken (Farmer, 1999; Haynes, Ackloo, Sahota, McDonald, & Yao, 2008; McDonald, Garg, & Haynes, 2002; Pullar, Kumar, Tindall, & Feely, 1989). A biological measure, derived from blood, saliva, or urine concentrations of medication, is generally considered to be the most accurate measure of adherence and is commonly used in other research fields such as epilepsy (Dutta & Reed, 2006; Herkes & Eadie, 1990; Landmark, Rytter, & Johannessen, 2007; Malone, Eadie, Addison, Wright, & Dickinson, 2006; Mitchell, Scheier, & Baker, 2000; Specht, Elsner, May, Schimichowski, & Thorbecke, 2003; Vermeire, Hearnshaw, Van Royen, & Denekens, 2001; Williams et al, 2001). Given varenicline’s pharmacokinetic attributes such as minimal metabolism and long half-life (approximately 24 hours) (Faessel et al, 2010), assessment of varenicline is a valid method for biologically assessing varenicline adherence.…”

Section: Introductionmentioning

confidence: 99%

Measures and predictors of varenicline adherence in the treatment of nicotine dependence

Peng

Morales

Wileyto

et al. 2017

Addictive Behaviors

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Introduction While adherence to medication in smoking cessation clinical trials is strongly associated with clinical outcome, very few studies have evaluated the validity of pill count as a measure of adherence relative to a biological assay, and evaluated a broad range of correlates of adherence. Methods In a smoking cessation clinical trial of varenicline, we compared pill counts collected over 4 different time periods to varenicline salivary levels taken after 2 weeks of treatment, as well as evaluated predictors of adherence to varenicline. Results Using a binary measure of adherence based on salivary varenicline levels, adherence was higher among older, white, and more educated participants. Relative to 3, 7, and 14-day pill count, 12-week pill count was the only significant measure able to discriminate adherence as defined by salivary varenicline levels (assessed by area under the receiver operating characteristic curve; AUC = .59, p =.004). Seventy-two percent of participants who indicated adherence on 12-week pill count were classified as adherent based on varenicline saliva levels (sensitivity=.80; specificity=.40). There was modest variability in the relationship between 12-week pill count and varenicline levels across race and rate of nicotine metabolism. Lastly, General Estimating Equation models demonstrated that longitudinal changes in withdrawal, craving, negative and positive affect, and side effect count and severity were not related to adherence based on salivary varenicline levels. Conclusions These results indicate that 12-week pill count was the best, albeit a relatively weak, measure of varenicline adherence; additional factors associated with treatment adherence need to be identified.

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Postictal serum levels of antiepileptic drugs for detection of noncompliance

Cited by 57 publications

References 36 publications

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting

Measures and predictors of varenicline adherence in the treatment of nicotine dependence

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