Adherence to treatment in patients with juvenile myoclonic epilepsy: correlation with quality of life and adverse effects of medication

Abstract

Purpose: To study the adherence to clinical treatment in patients with Juvenile Myoclonic Epilepsy (JME) and its correlation to Quality of Life (QOL) scores, and antiepileptic drugs (AEDs) adverse effects. Methods: Fortythree JME (ILAE,1989) outpatients in regular treatment were evaluated by clinical anamnesis and EEG/video-EEG at Hospital São Paulo, UNIFESP, Brazil. They answered a self-report questionnaire assessing adherence to treatment (scores 0 to 100), with higher scores meaning poorer adherence; Quality of Life in Epilepsy-31 (QOLIE-31) Brazilian validated version (scores 0 to 100), and the Adverse Events Profile (AEP), scores 19 to 76, in which scores ≥45 indicate toxicity; values less than 0.05 were considered statistically significant. Results: Sixteen patients (37,2%) were on monotherapy, while 26 (60.4%) on polytherapy. Twenty-two (48%) had experienced a seizure in the preceding three months of the survey. Mean adherence to treatment score was 68.5. AEP scores ≤45 were observed in 38 (88.3%), and 29 (67.4%) reported spontaneous adverse effects with AEDs. The most common adverse effects were sleepiness in 11(13.8%), and restlessness in 7(8.8%).QOLIE-31 highest mean score was 79.0 (Social Function), and the lowest 33.0 (Seizure Worry). Adherence to treatment presented good correlation to better QOL scores (Pearson<0.05), while higher AEP scores indicated poorer adherence (Pearson<0.05). Conclusions: Adherence to treatment showed high correlation to better QOL. The presence of adverse effects was negatively associated with adherence. Key-words: Adherence to treatment, antiepileptic drugs; adverse effects of medication, quality of life, juvenile myoclonic epilepsy. RESUMO Adesão ao tratamento em pacientes com Epilepsia Mioclônica Juvenil: correlação com qualidade de vida e efeitos adversos da medicaçãoObjetivos: Este estudo teve como objetivo avaliar a adesão ao tratamento com drogas antiepilépticas (DAEs) em pacientes com Epilepsia Mioclônica Juvenil (EMJ) e correlacionar com a Qualidade de Vida (QV) e com os efeitos adversos à medicação. Metodologia: A amostra foi composta de 43 pacientes com diagnóstico clínico e eletrográfico (EEG/Vídeo-EEG) de EMJ (ILAE,1989) (Pearson <0,05). Conclusão: A adesão ao tratamento mostrou alta correlação com uma melhor QV. A presença de efeitos adversos foi negativamente associada com a adesão ao tratamento.Unitermos: Adesão ao tratamento, drogas antiepilépticas, efeitos adversos à medicação, qualidade de vida, epilepsia mioclônica juvenil.

An evaluation of factors affecting adherence to antiepileptic drugs in patients with epilepsy: a cross-sectional study

“…(23) In the present study, we did not find any significant relationship between the occurrence of ADRs and adherence, even though ADRs that are related to the central nervous system may increase the likelihood of nonadherence. Our finding differs from that of Martins et al's study, (6) which found a statistically significant association between the occurrence of ADRs and AED adherence among their cohort, which consisted mainly of patients suffering from juvenile myoclonic epilepsy.…”

“…Several methods have been used to measure therapeutic adherence, including self-report, pill count, appointment attendance, medication refill history, blood or urine drug levels and drug diary. (6) Indirect methods, such as self-reports and patient interviews, are the simplest and most common methods used for measuring medication adherence. (7,8) To date, most of the studies conducted to evaluate AED adherence among PWE did not account for the influence of a wide range of variables (e.g.…”

Correlation between adherence to antiepileptic drugs and quality of life in patients with epilepsy: A longitudinal study

“…This indicates that, although epilepsy severity can determine the QoL in people with epilepsy [15,32], adherence seems to be more critical. Several studies have shown that medication adherence is well correlated with the QoL in patients with different illnesses [33][34][35], including epilepsy [12][13][14]. Our results further suggest that healthcare providers should strongly emphasize medication adherence among their patients.…”

“…Hovinga et al [12] also found that the QoL was lower in those with poor AED adherence in the previous month compared with that in patients adhering to their AED. Similarly, a study by Martins et al found a positive correlation between the level of medication adherence and QoL [13]. In addition, QoL is somewhat dependent on seizure control and seizure severity, as the level of QoL was found to be higher in patients who valued AEDs to control their seizures [14,15].…”

A Prospective Study on Impact of Patient Counselling on Quality of Life and Medication Adherence in Epileptic Patients

“…While categorizing epilepsy based on etiological factors, it is as genetics, acquired and unknown. Quality of life (QOL) is a subjective concept based on the subject's perspective and experiences and involves physical, psychological, social and cultural components, all of which contributes to patient's adjustment to his condition and impacts perception in his life [4,5]. The frequency and seizure severity, adverse effects of antiepileptic drugs (AEDs), seizure worry, mood status, physical, cognitive, and psychosocial limitations including dependence of caregivers are determinant aspects frequently assessed by QOL inventories [6].…”