title: Treatment adherence among adolescents with epilepsy: what really matters?
abstract: Treatment adherence is often suboptimal among adolescents with epilepsy. However, knowledge is lacking regarding factors that affect adherence. Empirical studies and theories of human development suggest that self-management skills, self-efficacy, and sense of control are related to adherence. Eighty-eight adolescents with epilepsy, and their parents, completed standardized measures assessing epilepsy knowledge and expectations, treatment self-management, sense of control, and self-efficacy. Better self-reported parent adherence was correlated with greater epilepsy knowledge/expectations (p<0.001) and more medications (p = 0.042). Better self-reported adolescent adherence was correlated with fewer siblings (p = 0.003) and higher adolescent epilepsy knowledge/expectations (p<0.001). Greater adolescent epilepsy knowledge/expectations correlated with parent self-reported adherence (p<0.001), Powerful others locus of control (p = 0.008), and adolescent/parent discordance regarding epilepsy knowledge/expectations (p<0.001). Interventions that enhance adolescent's knowledge of epilepsy and their treatment plan, while ensuring that teens and parents are in agreement with regard to epilepsy treatment, might contribute to better adherence.
authors: Department of Social Work, University of Michigan Health System, Ann Arbor, MI, USA. lbrach@med.umich.edu
authors: Loretta
authors: L
authors: Carbone
authors: Bradley
authors: B
authors: Zebrack
authors: Melissa
authors: M
authors: Plegue
authors: Sucheta
authors: S
authors: Joshi
authors: Renée
authors: R
authors: Shellhaas
mesh_terms: D000293:Adolescent; D002648:Child; D004827:Epilepsy / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D020377:Self Efficacy; D011795:Surveys and Questionnaires
references: Seizure. 2000 Dec;9(8):598-604
references: 11162760
references: Seizure. 1997 Apr;6(2):87-93
references: 9153719
references: Pediatrics. 2012 Jun;129(6):e1404-10
references: 22566417
references: Epilepsy Behav. 2010 May;18(1-2):94-9
references: 20452831
references: J Pers Assess. 1994 Dec;63(3):534-53
references: 7844739
references: Inflamm Bowel Dis. 2005 Nov;11(11):1006-12
references: 16239847
references: J Pediatr Psychol. 2006 Sep;31(8):846-58
references: 16401680
references: J Child Neurol. 2009 May;24(5):562-71
references: 19406756
references: JAMA. 2011 Apr 27;305(16):1669-76
references: 21521848
references: Seizure. 2002 Jan;11(1):33-9
references: 11888257
references: Addict Behav. 1994 Jan-Feb;19(1):1-12
references: 8197887
references: Epilepsia. 2011 Aug;52 Suppl 5:21-7
references: 21790562
references: J Pediatr Psychol. 2010 May;35(4):394-404
references: 19710251
references: Rheumatology (Oxford). 2006 Jan;45(1):92-6
references: 16287930
references: Pediatrics. 2006 Nov;118(5):1880-7
references: 17079558
references: Pediatrics. 2007 Oct;120(4):e804-14
references: 17908738
references: Ann Neurol. 2011 Mar;69(3):437-44
references: 21391239
references: J Pediatr Psychol. 2010 Mar;35(2):167-76
references: 19561010
references: J Pediatr Psychol. 2007 Aug;32(7):831-44
references: 17522111
references: J Pediatr Psychol. 2010 Mar;35(2):156-66
references: 19491214
references: J Dev Behav Pediatr. 2010 Jan;31(1):26-34
references: 20081433
references: J Pediatr Psychol. 2010 May;35(4):383-93
references: 19710252
references: J Pediatr. 2011 Feb;158(2):307-12
references: 20869068