Owner compliance in canine epilepsy

Abstract

Background: Poor medication compliance by human epilepsy patients is one of the leading causes of treatment failure and increased seizure frequency. The aim of this cross-sectional study was to analyse owner compliance in pharmacological treatment of canine idiopathic epilepsy and to identify factors associated with poor compliance. Methods: The number of antiseizure drug tablets was recorded to determine if the patient received sufficient tablets to cover the time period between prescriptions and to assess compliant prescription cycles. Additionally, compliance was assessed by an online survey of owners. Results: For the prescription monitoring data from 94 cases from three small animal practices in the United Kingdom revealed an overall median compliance of 56%. Thirty-three per cent of owners were ≥80% compliant, while 21% were 100% compliant. During a non-compliant prescription cycle, a patient missed a median of 6 days (0.11-519 days) of treatment. Patients on polytherapy had higher compliance rates than on monotherapy (p = 0.031). The survey (229 respondents from online canine epilepsy groups) showed that low daily dosing was associated with better compliance (p = 0.049). Conclusion: Owner compliance was subpar in this study and could represent a significant issue in epilepsy management, which needs to be considered by veterinary surgeons when treating canine epilepsy.

Compliance in canine epilepsy: can the owner be the cause of treatment failure?

“…These survey data showed higher compliance rates, with 56 per cent of owners reporting that they were 100 per cent compliant (ie, they had never missed a dose since the start of their dog's epilepsy treatment) and all participants reporting compliance of over 80 per cent. 10 The higher self-reported compliance rate may be the result of social desirability bias, where some respondents report an answer in a way they deem to be more socially acceptable than would be their 'true' answer. Unfortunately, the study population differed between the two analyses, so it is not possible to make direct comparisons between the datasets.…”

“…Furthermore, Booth and colleagues' survey data revealed that 23 per cent of the owners questioned admitted to having altered their pet's treatment regimen, 10 and it can be speculated that the true rate may be even higher. As such, in addition to potential non-compliance, the treating vet also has to be aware of the possibility of self-adjustments made by the owner.…”

“…8 Although it has been demonstrated that forgetting medication is an important seizure-precipitant in dogs with IE, 9 no studies have yet investigated the role of medication non-compliance in treatment failure in canine epilepsy. To help address this knowledge gap, Booth and colleagues performed a study, summarised on p 151 of this issue of Vet Record, 10 to investigate owner compliance in the pharmacological treatment of canine IE and identify factors associated with poor compliance.…”

“…3 In their study, Booth and colleagues used two data collection methods -prescription monitoring and an online survey -to provide both objective and subjective data to assess compliance. 10 In human medicine, patients are usually considered medication compliant when the number of pills taken in a given period is greater than 80 per cent of the number of pills prescribed in the same period. 3,8 Based on their prescription analysis, Booth and colleagues report that owners' overall median medication compliance was 56 per cent, with one-third of owners being at least 80 per cent compliant and only 21 per cent being 100 per cent compliant.…”

“…3,8 Based on their prescription analysis, Booth and colleagues report that owners' overall median medication compliance was 56 per cent, with one-third of owners being at least 80 per cent compliant and only 21 per cent being 100 per cent compliant. 10 Accordingly, if extrapolating the definition of non-compliance in human medicine to the data provided by Booth and colleagues, 67 per cent of their cases could be considered non-compliant. Studies in epileptic people show a wide range of reported non-compliance values (between 26 and 79 per cent), with these values partly depending on differences in the definition of non-compliance and cut-off values.…”