title: Patients' perspectives on antiepileptic medication: relationships between beliefs about medicines and adherence among patients with epilepsy in UK primary care.
abstract: BACKGROUND
  Nonadherence to antiepileptic drugs (AEDs) can result in suboptimal outcomes for patients.
  
  
  OBJECTIVE
  This study aimed to assess the utility of a theory-based approach to understanding patient perspectives on AEDs and adherence.
  
  
  METHODS
  Patients with epilepsy, identified by a GP case note review, were mailed validated questionnaires assessing their perceptions of AEDs and their adherence to them.
  
  
  RESULTS
  Most (84.9%) of the 398 AED-treated respondents accepted the necessity of AEDs, but over half expressed doubts, with 55% disagreeing or uncertain about the statement 'I would prefer to take epilepsy medication than risk a seizure'. Over a third (36.4%) expressed strong concerns about the potential negative effects of AEDs. We used self-report and medication possession ratio to classify 36.4% of patients as nonadherent. Nonadherence was related to beliefs about medicines and implicit attitudes toward AEDs (p<0.05). Adherence-related attitudes toward AEDs were correlated with general beliefs about pharmaceuticals (BMQ General: General Harm, General Overuse, and General Benefit scales) and perceptions of personal sensitivity to medicines (PSM scale).
  
  
  CONCLUSIONS
  We identified salient, adherence-related beliefs about AEDs. Patient-centered interventions to support medicine optimization for people with epilepsy should take account of these beliefs.
authors.affiliation: Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: S C E
authors.initials: SC
authors.lastname: Chapman
authors.affiliation: Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK. Electronic address: r.horne@ucl.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Horne
authors.affiliation: Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Chater
authors.affiliation: NEYNL CLRN, St John's University, York, UK.
authors.forename: D
authors.initials: D
authors.lastname: Hukins
authors.affiliation: Academic Unit of Primary Medical Care, Medical School, Samuel Fox House, Northern General Hospital, Sheffield, UK.
authors.forename: W H
authors.initials: WH
authors.lastname: Smithson
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D003469:Culture; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D011320:Primary Health Care; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Beliefs about Medicines Questionnaire (BMQ); Epilepsy; Medicine adherence; Perceived Sensitivity to Medicines (PSM) scale; Primary care