Nonadherence to treatment causing acute hospitalizations in people with epilepsy: An observational, prospective study

Abstract

Summary The aim was to assess the clinical relevance of antiepileptic drug (AED) nonadherence by means of therapeutic drug concentration monitoring (TDM). Two hundred eighty‐two consecutive patients with epilepsy acutely admitted to hospital for seizures were included. Nonadherence was defined as having a serum concentration/dose ratio at admission of <75% of the patient's own control value (probable nonadherence: 50–75%; definite: <50%). Nonadherence was identified in 39% of patients (definite 24%; probable 15%). It was significantly more common in patients with generalized seizures compared to those with focal onset seizures, and in patients <30 years compared to older patients. When specifically asked, 44% of nonadherent patients claimed regular intake. Nonadherence is a major cause of seizure breakthrough in patients with epilepsy, particularly in young adults. Many patients seem to be unaware of missed drug intake. Prompt measurements of AED serum concentrations should be available as part of the emergency care for patients acutely hospitalized for seizures to permit this issue to be thoroughly addressed prior to discharge.

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

“…This finding is similar to the results reported by Gabr and Shams, (17) but differs from the results of Kyngäs' study, which showed that a duration of epilepsy > 3 years was significantly related to adherence to medications. (18) However, a significant association between generalised epilepsy and nonadherence to AED was found in the present study, as well as in the study by Samsonsen et al; (19) the reason for this observation is elusive. One possible explanation that may account for the higher rate of adherence is that episodes of focal epilepsy are more frequent than generalised epilepsy.…”

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

“…In patients using AEDs at admission, serum concentrations were drawn in the emergency room and compared with drug-fasting steady state controls. Definite non-adherence was defined as a concentration/dose ratio on admission of 50% or lower compared to the control ratio (Samsonsen et al, 2014).…”

Plutselig, uventet epilepsirelatert død

“…p-piller) er viktig. Mange gjennombruddsanfall skyldes at pasienten har glemt å ta medisinene (42). Dette kan unngås ved for eksempel bruk av medisindosett og alarm på mobilen på tidspunkter for medisininntak.…”