Medication-taking behavior and drug self regulation in people with epilepsy

Abstract

-Objective: To study the most important characteristics of antiepileptic drug (AED) taking behavior in epileptic people. Methods: In a cross-sectional study, 45 consecutively seen patients answered a standardized questionnaire including questions about drug intake behavior. Results: Both genders were equally represented (22M x 23F). The mean age was 30.2 years. No specific characteristic were presented in all patients. The selfreported non-use of the drug at any moment one week before (self-reported non-adherence) was 40.0%. Patients took the drug more than once in most cases (75.0%), and the only precipitating factor of seizures more frequently avoided was alcohol intake (66.7%). Forty-four percent said to be afraid of becoming addicted to the medicine, 61.4% reduced or stopped the medicine just to see what would happen, and 47.7% changed the prescription with the same purpose. There is no relationship among socio-demographic, behavior aspects or treatment characteristics, and self-reported non-adherence. Conclusions: Several patient's aspects do not seem to be strongly correlated with self-reported adherence. Nevertheless, drug self-regulation is probably related to the drug-intake behavior, and it is important for the physician to understand this parallel influence on treatment for a more realistic approach.KEY WORDS: epilepsy, adherence, antiepileptic drug. Comportamento de auto regulação da ingesta de medicamentos em pessoas com epilepsiaRESUMO -Objetivo: Estudar as mais importantes características do comportamento de ingesta das drogas antiepilépticas (DAE) em pessoas com epilepsia. Método: Em estudo transversal, 45 pacientes consecutivamente vistos responderam a questionário padronizado sobre o comportamento de ingesta de DAE. Resultados: Ambos os sexos foram igualmente representados. A idade média foi 30,2 anos. Não há uma característica específica comum em todos os pacientes. O auto-referido não uso da DAE na semana anterior, em qualquer momento, (auto-referida não-aderência) foi de 40,0%. Pacientes ingeriram a droga mais de uma vez, em muitos casos (75,0%) e o único fator precipitante de crises epilépticas mais frequentemente evitado foi a ingesta de álcool (66,7%). Quarenta e quatro por cento se diziam preocupados em se tornarem dependentes do medicamento, 61,4% reduziram ou suspenderam a DAE apenas para ver o que acontecia e 47,7% mudaram as prescrições com o mesmo propósito. Não houve relação entre características sócio-demográficas, aspectos comportamentais ou características de tratamento, e auto-referida não aderência. Conclusões: Vários aspectos dos pacientes não parecem estar relacionados fortemente com a aderência auto-referida. No entanto, a auto regulação da ingesta de drogas é provavelmente relacionada ao comportamento íntimo de sua ingesta, e é importante para o médico entender essa influência paralela no tratamento para uma abordagem mais realística. PALAVRAS-CHAVE: epilepsia, aderência, droga antiepiléptica.Low adherence to prescribed medication by the physician is considered th...

Adherence to antiepileptic medicines in children: A multiple‐methods assessment involving dried blood spot sampling

“…The overall nonadherence rate to the AEDs, derived from the different measures, was 33%, which is within the reported range in international literature on the nonadherence to treatment in children with epilepsy of 3.5–58.0% (Lisk & Greene, ; Takaki et al., ; Shope, ; Hazzard et al., ; Gomes & Maia Filho, ; Kyngäs, ; Mitchell et al., ; Asadi‐Pooya, ; Conn et al., ; Modi et al., , ,b).…”

Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

“…[19] However, other studies reported a lower percentage of noncompliance of 40, 42, and 31.8%. [202122] All these studies used self-reported assessment of compliance and were also conducted at neurology clinic. There are studies reported higher rates of noncompliance using Morrisky scale.…”

Measures of adherence to epilepsy treatment: Review of present practices and recommendations for future directions

“…Self‐report measures are the most commonly used measurement in most studies of medication adherence (Osterberg & Blaschke, 2005), and self‐report methods such as surveys and interviews have been widely used to study adherence in epilepsy (Loiseau & Marchal, 1988; DiIorio & Henry, 1995; Gomes & Maia Filho, 1998; Mitchell et al, 2000; Paschal et al, 2005; Jones et al, 2006). Self‐report measures have the advantage of being low cost, noninvasive, and easily adaptable to a target population.…”

“…Instruments that specifically measure epilepsy treatment adherence are lacking, however, although more general self‐report measures may include items relevant to treatment adherence. Gomes & Maia Filho (1998) used a questionnaire that included one adherence question (“Did you forget or miss any of your medicine last week?”). Although judgment of adherence was based on that single question, other questions on the survey also addressed patient medication use behaviors.…”