Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy.
OBJECTIVE
Adherence to treatment is a critical component of epilepsy management. This study examines whether addressing antiepileptic drug (AED) side effects at every visit is associated with increased patient-reported medication adherence.


METHODS
This study identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits over a 3-year period. Demographic and clinical characteristics were abstracted. Evidence that AED side effects were addressed was measured through 1) phone interview (patient-reported) and 2) medical records abstraction (physician-documented). Medication adherence was assessed using the validated Morisky Medication Adherence Scale-4. Complete adherence was determined as answering "no" to all questions.


RESULTS
Sixty-two (25%) patients completed the interviews. Participants and nonparticipants were comparable with respect to demographic and clinical characteristics; however, a smaller proportion of participants had a history of drug-resistant epilepsy than nonparticipants (17.7% vs 30.9%,P=0.04). Among the participants, evidence that AED side effects were addressed was present in 48 (77%) medical records and reported by 51 (82%) patients. Twenty-eight (45%) patients reported complete medication adherence. The most common reason for incomplete adherence was missed medication due to forgetfulness (n=31, 91%). There was no association between addressing AED side effects (neither physician-documented nor patient-reported) and complete medication adherence (P=0.22 and 0.20).


CONCLUSIONS
Among patients with epilepsy, addressing medication side effects at every visit does not appear to increase patient-reported medication adherence.
Department of Neurology.
Lidia M V R
LM
Moura
Department of Neurology.
Thiago S
TS
Carneiro
Department of Neurology.
Andrew J
AJ
Cole
Mongan Institute for Health Policy, Department of Medicine, Massachusetts General Hospital; Department of Health Care Policy, Harvard Medical School, Boston, MA.
John
J
Hsu
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Barbara G
BG
Vickrey
Department of Neurology.
Daniel B
DB
Hoch
antiepileptic drug side effects; epilepsy; medication adherence