Early pediatric antiepileptic drug nonadherence is related to lower long-term seizure freedom.
OBJECTIVE
To examine the relationship between previously identified nonadherence trajectories during the first 6 months of antiepileptic drug (AED) therapy and long-term seizure-free rates (defined as ≥1 year of seizure freedom at the 4 years postdiagnosis milestone) in a cohort of children with newly diagnosed epilepsy.


METHODS
A prospective longitudinal observational study of AED adherence and seizure freedom in a consecutive cohort of 124 children (ages 2-12 years) with newly diagnosed epilepsy was conducted. The association between previously identified AED adherence trajectories (i.e., near-perfect adherence [e.g., average adherence = 96.8%] vs nonadherent) and seizure freedom for ≥1 year at the 4 years postdiagnosis milestone was determined.


RESULTS
Children who exhibited nonadherence to AED therapy in the first 6 months of treatment were 3.24 times more likely not to have achieved ≥1 year of seizure freedom at the 4 years postdiagnosis milestone compared to children in the near-perfect adherence group (χ² = 5.13; p = 0.02). Specifically, at the 4 years postdiagnosis milestone, only 12% of children in the near-perfect adherence group were continuing to experience seizures compared to 31% of children in the nonadherent group.


CONCLUSIONS
Children with epilepsy who achieved near-perfect adherence during the first 6 months of therapy experienced a higher rate of seizure freedom 4 years postdiagnosis compared with those children who demonstrated early nonadherence. This suggests that adherence intervention early in the course of treatment could play a role in improving long-term seizure freedom rates in children with epilepsy.
From the Cincinnati Children's Hospital Medical Center, OH.
Avani C
AC
Modi
Joseph R
JR
Rausch
Tracy A
TA
Glauser
D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy*; D013995:Time; D016896:Treatment Outcome
D000927:Anticonvulsants