Measures of adherence to epilepsy treatment: review of present practices and recommendations for future directions.
Epilepsy is one of the most common neurological disorders worldwide, and the majority of people with epilepsy who live in developed countries manage their condition with antiseizure medication. Surprisingly, therefore, the literature on epilepsy does not document a comprehensive investigation of patient adherence to medication treatment. This paper reviews existing literature on direct and indirect measures of adherence. Based on this review, areas in need for further research have been identified, including improvement of self-report instruments, consideration of cultural factors, attention to patient literacy or numeracy levels, and inclusion of patient-guided measures. While no single method of determining adherence has proved effective, combining direct and indirect measures in a patient-guided, culturally competent atmosphere may increase adherence to treatment, improving health outcomes for this population.
Paschal
Angelia M
AM
Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas 67214-3199, USA. apaschal@kumc.edu
Hawley
Suzanne R
SR
St Romain
Theresa
T
Ablah
Elizabeth
E
D000927:Anticonvulsants / Q000032:analysis / Q000097:blood / Q000627:therapeutic use*; D003071:Cognition; D003469:Culture; D004827:Epilepsy / Q000188:drug therapy*; D005544:Forecasting; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006197:Hair / Q000737:chemistry; D015438:Health Behavior; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012463:Saliva / Q000737:chemistry
D000927:Anticonvulsants