Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs

Abstract

Results: Low adherence was related to AED beliefs (doubts about necessity: t(577) = 3.90, p < 0.001) and concerns: t(995) = 3.45, p = 0.001), reported limitations in capability and resources (t(589) = 7.78, p < 0.001) and to perceptions of a lack of involvement in treatment decisions (t(623) = 4.48, p < 0.001). In multiple logistic regression analyses, these factors significantly (p < 0.001) increased variance in reported adherence, above that which could be explained by age and clinical variables (seizure frequency, type, epilepsy duration, number of AEDs prescribed).Significance: Variables identified in the NICE Medicines Adherence Guidelines as potentially important factors for adherence were found to be related to adherence to AEDs. These factors are potentially modifiable. Interventions to support optimal adherence to AEDs should be tailored to address doubts about AED necessity and concerns about harm, and to overcome practical difficulties, while engaging patients in treatment decisions

Discrepancies between physicians' prescriptions and patients' use of antiepileptic drugs

“…This qualitative approach confirmed the attitudes of patients described in recent studies from the UK. Beliefs of AEDs related to doubts about necessity, concerns, limitations in capability, and resources or perceptions of a lack of involvement in treatment decisions have all been documented quantitatively as contributing factors to poor adherence (12,13). Our results support these prior findings.…”

“…Non-adherence is a well-known and important clinical problem that increases health-related costs and is a major reason for seizure breakthrough (9)(10)(11)(12)(13). Adherence is the process in which the appropriate treatment is decided after a proper discussion with the patient as a shared decision and is further described as the extent to which the patients are taking their medication corresponds with agreed recommendation from a healthcare professional (14)(15)(16)(17).…”

Translation and initial validation of the Medication Adherence Report Scale (MARS) in Italian patients with Crohn’s Disease

“…It is a generic tool, which can be administered regardless of the disease and the prescribed drug. It has been validated so far in different clinical settings, namely statin therapy [15], rheumatoid arthritis [16], asthma [17], psychosis [18], and has been used for assessing adherence in many clinical studies worldwide [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

A prospective observational study to assess compliance and factors influencing compliance with antiepileptic drugs among patients with epilepsy

“…8 Approximately 21-42% of patients prescribed AEDs for epilepsy do not adhere to their prescribed treatment. 3 The present study provides the insights of current trend of compliance to antiepileptic drugs and factors which affect compliance in community.…”