A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence

Abstract

Purpose: 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.

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

“…Importantly, it has been shown that nearly 60% of patients could achieve seizure control by adhering to prescribed antiepileptic drugs (AEDs) [6]. However, it has been reported that 30%-50% of patients with epilepsy were nonadherent with their AED treatment schedules [7][8][9]. Thus, nonadherence is a critical issue for patients with epilepsy [10].…”

The impact of sleep loss on the facilitation of seizures: A prospective case-crossover study

“…doubts about the need for AEDs, concerns about adverse effects and practical factors influencing medication taking have been emphasized recently (Chapman et al, 2014 andPakpour et al, 2015). Accordingly, the management should focus on the individual 40 non-adherence pattern, tailoring the intervention to the patient profile (Blaschke et al, 2012;Eatock and Baker, 2007).…”

Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications

“…It is estimated that 70% of patients will respond to the medicines prescribed whilst the remainder will need surgery and other forms of therapy to achieve seizure control [2,3,4].…”

“…AEs are contributors to poor drug compliance, which can be as high as 30% to 50% of adults living with epilepsy, low quality of life and drop outs from drug therapy [4,5,9]. AEs include neuropsychiatric, gastrointestinal, dermatological, endocrine and haematological side-effects.…”