Project EASE: a study to test a psychosocial model of epilepsy medication management

DiIorio, Colleen; Shafer, Patricia Osborne; Letz, Richard; Henry, Thomas R.; Schomer, Donald L.; Yeager, Kate

doi:10.1016/j.yebeh.2004.08.011

Cited by 123 publications

(99 citation statements)

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“…In addition, low self-efficacious people are prone to self-disparaging thoughts and demoralization that in turn lead to depressive ideation. The latter proposition is supported by empirical evidence showing a relationship between self-efficacy and depression (Arnstein et al 1999;DiIorio et al 2004;Ong and Walsh 2001). Moreover, several investigators have found that higher levels of depression correspond to lower levels of ART adherence (Ammassari et al 2004;Gonzalez et al 2004;Kleeberger et al 2004).…”

Section: Theoretical Perspectivementioning

confidence: 82%

“…Our results are not unlike those of other investigators who have found that outcome expectancy may not be as strong a variable when other relationships are considered within adherence models. In a path analysis of epilepsy medication management, DiIorio et al (2004) also reported a lack of association between outcome expectancy and self-management. In the full model, it was interesting to note that the paths o (spirituality), p (decision-making), and q (patient satisfaction) leading to outcome expectancy were statistically significant.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

et al. 2007

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Objective-The primary aim of this study was to test a psychosocial model of medication adherence among people taking antiretroviral medications. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectancy, stigma, depression, and spirituality), social (social support, difficult life circumstances), and provider (patient satisfaction and decision-making) variables. © Springer Science+Business Media, LLC 2007Correspondence to: Colleen DiIorio, cdiiori@sph.emory.edu. Design-The data for this analysis were obtained from the parent study, which was a randomized controlled trial (Get Busy Living) designed to evaluate an intervention to foster medication adherence. Factor analysis was used to develop the constructs for the model, and structural equation modeling was used to test the model. Only baseline data were used in this cross sectional analysis. NIH Public AccessMethods-Participants were recruited from a HIV/AIDS clinic in Atlanta, GA. Prior to group assignment, participants were asked to complete a questionnaire that included assessment of the study variables.Results-A total of 236 participants were included in the analysis. The mean age of the participants was 41 years; the majority were male, and most were African-American. In the final model, self-efficacy and depression demonstrated direct associations with adherence; whereas stigma, patient satisfaction, and social support were indirectly related to adherence through their association with either self-efficacy or depression.Conclusion-These findings provide evidence to reinforce the belief that medication-taking behaviors are affected by a complex set of interactions among psychosocial variables and provide direction for adherence interventions.

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Section: Theoretical Perspectivementioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

et al. 2007

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“…Para avaliar o processo, foram aplicados questionários a respeito do seu conhecimento, sua atitude e percepção perante à epilepsia (KAP) antes dos cursos (pré-teste) e após a intervenção (pós-teste). Resultados: A comparação feita a respeito do conhecimento com médicos mostrou que os mesmos melhoram seu conhecimento com os cursos (pré-teste: nota média=55.8; DP=14,0) vs. pós-teste: nota média=71,5; DP=12,0;8; p<0,001). O mesmo padrão ocorreu com os agentes comunitários de saúde: pré-teste: nota média=22.3; DP=12,5) vs. pós-teste: nota média=36,6; DP=12,5; t-test=12,4; p<0,001.…”

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“…In addition to medical knowledge, a psychosocial approach is re q u i red to improve seizure cont ro l 1 . To some extent, a positive attitude held by health professionals helps to promote appro p r i a t e behaviour by patients 8 .…”

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confidence: 99%

Training the trainers and disseminating information: a strategy to educate health professionals on epilepsy

Fernándes

Noronha

Sander

et al. 2007

Arq. Neuro-Psiquiatr.

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-Purpose: To evaluate the knowledge, attitudes and perceptions of epilepsy in primary care system health professionals prior to and after an educational intervention. Methods: Educational interventions were delivered to three groups of people with an interest in epilepsy: 1. Information courses for physicians (241 subjects); 2. Social re-integration course for health professionals and community leaders (631 subjects); 3. "Training the Trainers" Course for physicians (11 subjects). The whole program is flexible and can be tailored for local or regional needs. For the evaluation of this process, health professionals completed a quantitative and qualitative questionnaire to assess their knowledge, attitudes and perc e p t i o n (KAP) of epilepsy prior to the training (pre-test) and 6 months after it (post-test). Results: Comparison of knowledge scores prior to (mean=55.8, standard deviation=14.0) and after (mean=71.5, standard deviation=12.0) the intervention showed that physicians had improved knowledge after the training (t-test=7.8, p<0.001). The same pattern occurred with the health professionals: the knowledge score prior to (mean=22.3, s t a n d a rddeviation=12.5) and after (mean=36.6, standard deviation=12.5) the intervention showed that health professionals had improved knowledge after the training (t-test=12.4, p<0.001). Improvements in attitudes and perception also occurred after the courses. Discussion: Training courses can promote incre a s e d knowledge, attitude and perception in a cost effective way in the primary care setting. However, a continuous education program is re q u i red to correct oversights and to improve the management of people with epilepsy.KEY WORDS: training, educational courses, epilepsy, primary health care, education.Capacitações e multiplicadores: uma estratégia para educação de profissionais da área de saúde na epilepsia RESUMO -Objetivo: Avaliar conhecimentos, atitudes e percepção sobre epilepsia de profissionais da saúde do sistema de atenção básica antes e depois de curso de capacitação. Método: Cursos de capacitação foram realizados em três grupos de profissionais de saúde: 1. cursos de capacitação para médicos (241 sujeitos); 2. cursos de inserção social para agentes comunitários de saúde (631 sujeitos); 3. cursos de replic a d o res para médicos (11 sujeitos). O programa de capacitação foi adaptado para as condições de cada local. Para avaliar o processo, foram aplicados questionários a respeito do seu conhecimento, sua atitude e percepção perante à epilepsia (KAP) antes dos cursos (pré-teste) e após a intervenção (pós-teste). Resultados: A comparação feita a respeito do conhecimento com médicos mostrou que os mesmos melhoram seu conhecimento com os cursos (pré-teste: nota média=55.8; DP=14,0) vs. pós-teste: nota média=71,5; DP=12,0;8; p<0,001). O mesmo padrão ocorreu com os agentes comunitários de saúde: pré-teste: nota média=22.3; DP=12,5) vs. pós-teste: nota média=36,6; DP=12,5; t-test=12,4; p<0,001. Com relação a atitudes e percepção, foram observadas melho...

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“…Non-adherence rates among patients with epilepsy range from 30-50%. 2 Clinicians treating epilepsy patients note that non-adherent patients report more difficulty in attaining seizure control than patients adherent with their medication. Uncontrolled seizures lead to major morbidity and mortality, including physical injury such as head trauma, fractures and burns, also psychosocial problems such as depression and anxiety, decreased quality of life and sudden unexpected death.…”

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confidence: 99%

Pharmacological management of epilepsy

Brown¹

2016

Prog Neurol Psychiatry

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There have been significant advances in the management of epilepsy since the appearance of bromide in 1857. In the last decade, many new drugs have been developed and general understanding of the condition has improved. Here, Pharmacist Epilepsy Practitioner, Carole Brown, considers the current choice of antiepileptic drugs (AEDs), mode of action, newer AEDS, when to start treatment, epilepsy guidelines, adverse effects of AEDs, generic substitution, therapeutic drug monitoring, driving, contraception and bone health.

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Project EASE: a study to test a psychosocial model of epilepsy medication management

Cited by 123 publications

References 40 publications

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

Training the trainers and disseminating information: a strategy to educate health professionals on epilepsy

Pharmacological management of epilepsy

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