Monitoring Drug Noncompliance in Epileptic Patients

Takaki, Seiichiro; Kurokawa, Toru; Aoyama, Toshinobu

doi:10.1097/00007691-198503000-00015

Cited by 28 publications

(9 citation statements)

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“…The severity of the disease does not take part in this behavior, as shown in our study, but Peterson and col. 5 related it to compliance. Takaki and col. 8 did not show correlation between adherence and type of seizure, unlike Peterson and col. 5 .…”

Section: Discussionmentioning

confidence: 59%

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

Gomes¹,

Filho²

1998

Arq. Neuro-Psiquiatr.

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-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...

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Section: Discussionmentioning

confidence: 59%

“…The items pool has been reduced by previous studies on adherence measures [3][4][5]8 that have given us clues for the most consistent items of medication-taking behavior and other attributes related to adherence. Pre-tests were done.…”

Section: Methodsmentioning

confidence: 99%

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

Gomes¹,

Filho²

1998

Arq. Neuro-Psiquiatr.

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“…Such patients could be fully compliant but might be omitting up to 35% of their tablets. However, studies in epilepsy (Feely et al, 1980;Takki et al, 1985) and observations in our volunteers suggest that intraindividual variation in the relationship of level to dose is considerably less than interindividual variation. In long-term studies serial measurements might permit the detection of quite modest (> 15%) omissions of treatment, particularly where an initial measurement was made during supervised administration.…”

Section: Discussionmentioning

confidence: 62%

Low‐dose phenobarbitone as an indicator of compliance with drug therapy.

Feely

Cooke

Price

et al. 1987

Brit J Clinical Pharma

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1 To assess the potential value of low-dose phenobarbitone (PB) as a marker of compliance we studied the relationship between plasma level of PB and dose (2-16 mg daily) following 3 or 4 weeks treatment in healthy volunteers (n = 26) and in-patient volunteers (n = 7). 2 Also, to simulate poor compliance, PB levels were measured in some volunteers following alternate-day (n = 6) or short-term (n = 5) treatment with similar doses. These levels, expressed as the level: dose ratios (LDRs), did not overlap with those obtained following 3 or 4 weeks of daily PB intake. 3 To evaluate the efficacy of this marker in patients taking other drugs we gave a group of out-patients (n = 24) compound tablets containing B vitamins and a small dose (16 mg) of PB; their compliance over 2-5 weeks was assessed both by measuring plasma levels of PB and residual tablet counting. 4 In the latter study, as well as providing absolute evidence of good compliance by many patients, the plasma levels of PB proved particularly valuable when non-compliant individuals 'forgot' to bring their residual tablets. 5 We suggest that phenobarbitone, in doses low enough to be non-sedative and nonenzyme inducing, is potentially useful as a pharmacological indicator of compliance with drug therapy.

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“…Nonadherence is not an issue in institutionalized subjects where medication intake is directly observed by the staff. 11 The second possibility is emerging drug tolerance resulting from increased metabolism due to enzyme induction. These 2 factors can be excluded if the serum concentrations of AEDs are within the therapeutic range.…”

Section: Discussionmentioning

confidence: 99%