title: Psychosocial factors associated with medication adherence in ethnically and socioeconomically diverse patients with epilepsy.
abstract: The current study examined psychosocial correlates of medication adherence in a socioeconomically and racially diverse sample of patients with epilepsy. Fifty-five patients with epilepsy completed standardized self-report questionnaires measuring depression, stress, social support, and medication and illness beliefs. Antiepileptic drug (AED) adherence was measured using the 8-item Morisky Medication Adherence Scale 36% reported poor adherence. We tested which psychosocial factors were independently and most strongly associated with AED adherence. Stress and depression were negatively correlated with adherence, while perceived social support was positively correlated with adherence (Ps<.05). When all three of these variables and relevant covariates in a multiple regression model were included, only perceived social support remained a significant predictor of adherence (P=.015). This study is one of the first to suggest the importance of targeting social support in screening and intervention approaches in order to improve AED adherence among low-income, racially/ethnically diverse patients with epilepsy.
authors.affiliation: Department of Population Health, New York University, School of Medicine, USA. Electronic address: Amanda.shallcross@nyumc.org.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Shallcross
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Becker
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Friedman
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Jurd
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: French
authors.affiliation: Department of Neurology, New York University, School of Medicine, USA.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.affiliation: Department of Population Health, New York University, School of Medicine, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Spruill
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology; D005006:Ethnicity / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology*; D008875:Middle Aged; D009519:New York City / Q000208:ethnology; D012923:Social Class; D012944:Social Support
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy; Medication adherence; Minority patients; Psychosocial factors; Race/ethnicity; Social support
references.citation: J Psychosom Res. 2006 Jun;60(6):631-7
references.pmid: 16731240
references.citation: J Health Soc Behav. 1983 Dec;24(4):385-96
references.pmid: 6668417
references.citation: Psychol Health Med. 2007 Jan;12(1):107-13
references.pmid: 17129938
references.citation: J Clin Hypertens (Greenwich). 2008 May;10(5):348-54
references.pmid: 18453793
references.citation: Epilepsy Behav. 2008 Aug;13(2):316-22
references.pmid: 18472303
references.citation: J Hypertens. 2010 Sep;28(9):1785-95
references.pmid: 20531223
references.citation: Cochrane Database Syst Rev. 2011;(1):CD008312
references.pmid: 21249705
references.citation: Am J Geriatr Pharmacother. 2011 Feb;9(1):11-23
references.pmid: 21459305
references.citation: Epilepsy Behav. 2011 Nov;22(3):584-6
references.pmid: 21907627
references.citation: Epilepsia. 2012 Feb;53(2):e25-8
references.pmid: 22091925
references.citation: Popul Health Manag. 2012 Oct;15(5):253-60
references.pmid: 22401152
references.citation: Epilepsy Behav. 2012 Dec;25(4):614-21
references.pmid: 23160097
references.citation: Epilepsy Res. 2013 Feb;103(2-3):279-87
references.pmid: 22858309
references.citation: Psychol Assess. 2014 Jun;26(2):384-94
references.pmid: 24320763
references.citation: Epilepsy Behav. 2014 Jul;36:138-43
references.pmid: 24926942
references.citation: Health Psychol. 2004 Mar;23(2):207-18
references.pmid: 15008666
references.citation: Lancet Neurol. 2006 May;5(5):399-405
references.pmid: 16632310
references.citation: Epilepsy Behav. 2006 Feb;8(1):232-8
references.pmid: 16356782
references.citation: Seizure. 2006 Oct;15(7):504-8
references.pmid: 16861012