title: A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence.
abstract: OBJECTIVE
  Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy.
  
  
  METHODS
  In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed.
  
  
  RESULTS
  In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns.
  
  
  CONCLUSIONS
  This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence.
authors.affiliation: Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. Electronic address: Pakpour_Amir@yahoo.com.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Pakpour
authors.affiliation: Department of Health Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany.
authors.forename: Maryam
authors.initials: M
authors.lastname: Gholami
authors.affiliation: Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Ravanbakhsh
authors.initials: R
authors.lastname: Esmaeili
authors.affiliation: Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Seyed Abolhasan
authors.initials: SA
authors.lastname: Naghibi
authors.affiliation: Department of Psychological Sciences, Kent State University, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Updegraff
authors.affiliation: School of Psychology, National University of Ireland, Galway, Ireland.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.affiliation: School of Natural Sciences, University of Stirling, Cottrell Building, FK9 4LA Stirling, UK.
authors.forename: Stephan U
authors.initials: SU
authors.lastname: Dombrowski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods*; D017028:Caregivers; D004311:Double-Blind Method; D004827:Epilepsy / Q000188:drug therapy*; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D057566:Self Report; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy medical adherence; Motivational interviewing; Planning; Self-monitoring