Strategies for improving adherence to antiepileptic drug treatment in patients with epilepsy

Prevalence and determinants of medication non‐adherence in chronic pain patients: a systematic review

“…Interventions that improved medication adherence are mostly described in other chronic conditions: simplification of the medication regimen, patient education, behavioral interventions (reminders, encouragement), SMS reminders, and eHealth‐interventions . Interventions to improve non‐intentional non‐adherence, e.g., SMS reminders, may be more easily implemented than interventions for intentional non‐adherence in a chronic pain population.…”

“…A meta‐analysis of 569 studies reported an average non‐adherence rate across diseases of 20.6% . Determinants of non‐compliance as well as successful interventions have been presented to improve compliance and treatment outcome …”

Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs

“…[3][4][5][6][7] This nonadherence is associated with increases in seizure risk, 8 risk of hospitalization and treatment costs, 9,10 and premature mortality. 11 A number of interventions have been designed to support people with epilepsy to self-manage their medications and/ or adhere to their medication (e.g., Noble et al 12 and Fogg et al 13 ; for review of randomized controlled trials (RCTs) see Al-Aqeel and Al-Sabhan 14 ). However, many interventions are not successful, and, even for those that are successful, many patients in the intervention group do not achieve high levels of adherence.…”

“…However, many interventions are not successful, and, even for those that are successful, many patients in the intervention group do not achieve high levels of adherence. 14 A comprehensive review, commissioned by the UK National Institute of Health Research (NIHR), examined the reasons that interventions to facilitate adherence to medication for long-term conditions have met with only limited success. 15 This drew on theories of medication adherence and explanatory studies that had identified potentially modifiable determinants of nonadherence across a range of long-term conditions, to recommend a Perceptions and Practicalities Approach (PAPA) for supporting adherence.…”

Health-care costs and utilization related to long- or short-acting antiepileptic monotherapy use

“…Lack of adherence to AEDs has been linked to increased burden of illness, and previous studies have examined the impact of nonadherence to AEDs on health-care utilization and costs [4][5][6]. Moreover, educational and behavioral interventions to improve adherence to AEDs in patients with epilepsy have had only mixed results [15]. The lack of studies that assessed whether AEDs of long half-life or with long duration of action might mitigate the impact of poor adherence on healthcare utilization and costs was the impetus for the current study.…”