title: Drug adherence of patients with epilepsy in Iran: the effects of the international economic sanctions.
abstract: Drug adherence of patients with epilepsy was investigated to determine the reasons behind poor adherence. In this retrospective chart review study, all patients with a clinical diagnosis of epilepsy were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences. We routinely asked about the patient's drug adherence and reasons behind poor drug adherence in every office visit. We defined drug adherence adequate if the patient reported less than or equal to one missed dose per month. Patients' drug adherences were investigated during two time periods: March 2010-2011 (before intensification of the international economic sanctions against Iran), and September 2012-2013 (during intensified international economic sanctions). One hundred and ninety-nine patients were studied. Drug adherence was satisfactory in 139 patients (69.8 %) during the first time period. Drug adherence was satisfactory in 146 patients (73.4 %) during the second time period. The most common reasons for poor drug adherence was carelessness, followed by cost and lack of drug availability (1.5 % in the first time period and 4 % in the second time period; P = 0.07). About one-third of patients with epilepsy had poor drug adherence. To overcome the problem, it is important to find the reasons behind poor drug adherence in each patient and try to overcome the cause. Purely from a clinical and patient care perspective, it seems necessary that politicians should facilitate decisions that make the health and well-being of ordinary people more affordable and without hardship.
authors.affiliation: Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran. aliasadipooya@yahoo.com.|Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, USA. aliasadipooya@yahoo.com.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Asadi-Pooya
authors.affiliation: Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Bita
authors.initials: B
authors.lastname: Tavana
authors.affiliation: Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Tavana
authors.affiliation: Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Emami
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007492:Iran; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000927:Anticonvulsants
keywords: Cost; Drug adherence; Economic sanctions; Epilepsy