title: Behavioral predictors of medication adherence trajectories among youth with newly diagnosed epilepsy.
abstract: OBJECTIVE
  This study aimed to identify psychosocial predictors of two-year antiepileptic drug (AED) adherence trajectories among youth with newly diagnosed epilepsy, controlling for known demographic and medical factors.
  
  
  METHODS
  This study is part of a large, prospective, longitudinal observational study of AED adherence and medical outcomes in youth with newly diagnosed epilepsy. Parents completed questionnaires of psychosocial and family functioning at one month and one year following diagnosis. Chart review and questionnaires were used to collect medical variables and seizure outcomes. Previously established two-year AED adherence trajectories (Severe Early Nonadherence, Variable Nonadherence, Moderate Nonadherence, High Adherence) were used as the outcome variable.
  
  
  RESULTS
  Participants were 91 parents of youth with epilepsy (7.3±2.8years of age; 60% male) and their families. Early (one month following diagnosis) predictors of two-year adherence trajectories included socioeconomic status, epilepsy knowledge, family problem-solving, and family communication. Significant predictors one year following diagnosis included socioeconomic status, parent fears and concerns, and parent life stress.
  
  
  CONCLUSIONS
  There are modifiable parent and family variables that predict two-year adherence trajectories above and beyond known medical (e.g., seizures, side effects) factors. Psychosocial interventions delivered at key points during the course of epilepsy treatment could have a positive impact on adherence outcomes.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA. Electronic address: kristin.loiselle@cchmc.org.
authors.forename: Kristin
authors.initials: K
authors.lastname: Loiselle
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA. Electronic address: joseph.rausch@cchmc.org.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Rausch
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA. Electronic address: avani.modi@cchmc.org.
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012923:Social Class; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants
keywords: Adherence; Epilepsy; Pediatric; Psychological factors