title: Factors influencing medication adherence after epilepsy surgery.
abstract: OBJECTIVE
  In drug-responsive epilepsy patients, treatment non-compliance is a major factor in seizure recurrence, but adherence to prescribed regimens following epilepsy surgery has not been examined. We measured adherence to prescribed antiepileptic drugs (AEDs) after epilepsy surgery and investigated factors influencing treatment non-compliance.
  
  
  METHODS
  Postsurgical epilepsy patients (n=214) were monitored for 18.1±8.1 months. Adherence was measured using the Medication Possession Ratio (MPR) self-report questionnaire, with MPR<0.8 defined as non-adherence.
  
  
  RESULTS
  According to the MPR, 58 patients (27.1%) were non-adherent after surgery. There were no differences in demographic and clinical variables, such as age (p=0.057, t=-1.925), duration of illness (p=0.597, t=0.530), gender ratio (p=0.714, χ2=0.134), and place of residence (urban vs. rural; p=0.874, χ2=0.025), between adherent and non-adherent patients. Moreover, adherence was not related to surgical outcome as evaluated by the Engel classification (p=0.635, χ2=1.628) or to the types of AEDs after surgery (p=0.165, χ2=6.530). The most common reasons for non-adherence were seizure-free status for an extended period (26.5%), forgetfulness (19.1%), and an inability to buy the drugs locally (18.6%).
  
  
  CONCLUSIONS
  Adherence to AEDs is improved after epilepsy surgery compared to presurgical estimates, but is still a common and serious problem. Targeted postsurgical management programs and communication strategies are necessary to improve adherence to AEDs after epilepsy surgery.
authors: Affiliated Bayi Brain Hospital, Bayi Clinical College, Southern Medical University, Beijing, China.
authors: Jianming
authors: J
authors: Liu
authors: Affiliated Bayi Brain Hospital, Bayi Clinical College, Southern Medical University, Beijing, China.
authors: Ruxiang
authors: R
authors: Xu
authors: Affiliated Bayi Brain Hospital, Bayi Clinical College, Southern Medical University, Beijing, China.
authors: Zhiliang
authors: Z
authors: Liu
authors: Affiliated Bayi Brain Hospital, Bayi Clinical College, Southern Medical University, Beijing, China.
authors: Yu
authors: Y
authors: You
authors: Affiliated Bayi Brain Hospital, Bayi Clinical College, Southern Medical University, Beijing, China.
authors: Fanxin
authors: F
authors: Meng
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004827:Epilepsy / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012959:Socioeconomic Factors; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000927:Anticonvulsants
keywords: adherence; antiepileptic drugs; epilepsy surgery; follow-up studies; treatment outcome