Strategies for improving adherence to antiepileptic drug treatment in people with epilepsy

Al-Aqeel, Sinaa; Gershuni, Olga; Al-sabhan, Jawza; Hiligsmann, Mickaël

doi:10.1002/14651858.cd008312.pub3

Cited by 42 publications

(21 citation statements)

References 57 publications

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“…The ESPACOMP Medication Adherence Reporting Guideline (EMERGE) was developed to help researchers improve the quality of their reporting of medication adherence research, as this type of research is often methodologically weak (8,35,36) and suboptimally reported (11)(12)(13). While EMERGE has the advantage of being applicable to multiple study designs and methods focusing on medication adherence, its use will involve authors combining EMERGE items with other appropriate guidelines for health research reporting (e.g., STROBE, CONSORT, STaRi).…”

Section: Discussionmentioning

confidence: 99%

ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

et al. 2018

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Research on assessing or managing medication adherence applies approaches from observational, interventional, and implementation science that spans many disciplines and demands coherent conceptualization, valid methods, appropriate analyses, and complete and accurate reporting. To ensure such reporting, the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) Medication Adherence Reporting Guideline (EMERGE) recommends standard reporting approaches based on an accepted taxonomy. This guideline is derived from a literature review, a reactive Delphi study with 26 medication adherence experts from many countries and disciplines, and feedback from ESPACOMP members. It is designed to supplement existing guidelines for health research reporting and is structured around 4 minimum reporting criteria and 17 items reflecting best reporting practice. By enhancing and harmonizing research reporting, EMERGE aims to advance research and, ultimately, patient outcomes.

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Section: Discussionmentioning

confidence: 99%

ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

et al. 2018

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“…32 These interventions range from routine counseling by a pharmacist or nurse, to immersive one-on-one educational programs that include behavioral interventions. 32 These interventions range from routine counseling by a pharmacist or nurse, to immersive one-on-one educational programs that include behavioral interventions.…”

Section: Discussionmentioning

confidence: 99%

“…14,15,30,31 Although improved adherence is related to improved outcomes, it is not the standard of practice to address adherence issues. 16,32 In contrast, escalation of the ASD dose is a common first-line practice when seeking to improve seizure control. 16 This is not a benign intervention and exposes the patient to increased risks of ASD dose-related adverse events.…”

Section: Discussionmentioning

confidence: 99%

“…Previous work has identified interventions in patients that both improve adherence and reduce seizure frequency. 32 These interventions range from routine counseling by a pharmacist or nurse, to immersive one-on-one educational programs that include behavioral interventions. However, prior to the initiation of any intervention to improve adherence, the problem must first be identified.…”

Section: Discussionmentioning

confidence: 99%

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Correction of medication nonadherence results in better seizure outcomes than dose escalation in a novel preclinical epilepsy model of adherence

et al. 2019

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Summary Objective Medication nonadherence directly contributes to poor seizure control. A lack of emphasis on correcting poor adherence and failures in patient adherence can result in unwarranted alterations to a patient's drug regimen. We have modeled nonadherent patients in an animal model of epilepsy to study how alterations to pharmacotherapy, made without consideration of a patient's adherence, result in changes to seizure control. Methods Newly diagnosed rats with epilepsy were treated with carbamazepine (CBZ) during a 4‐week baseline period to establish their baseline seizure rate in the presence of 50% adherence. Next, animals were randomized to one of three treatment interventions and monitored for 6 weeks. Groups included: (1) no change in therapy—rats continued the 50% adherent paradigm; (2) dose escalation—the dose of CBZ was doubled, and the 50% adherent paradigm continued; and (3) nonadherence corrected—rats continued the initial dose of CBZ, but the adherence rate was adjusted to 100% (ie, fully adherent). Results The rats in the no change in therapy arm displayed a 61% increase in seizure burden over the 6‐week intervention phase. Similarly, rats in the dose escalation arm had a 66% worsening of their daily seizure burden. In contrast, rats in the nonadherence corrected arm displayed a 33% reduction in their daily seizure burden; a significant improvement when compared to the normalized seizure burden scores of rats in the other two treatment arms (P < 0.01). Significance We found that failure to correct medication nonadherence resulted in an increase in daily seizure burden in rats, even following dose escalation. In the presence of nonadherence, dose escalation worsened seizure control. In contrast, correcting nonadherence alone resulted in improved seizure control. These findings suggest that improving adherence should be prioritized over dose escalation in the clinical management of uncontrolled epilepsy.

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“…Previous evidence on the effectiveness of educational interventions in terms of medication adherence in patients with epilepsy is mixed 12. Li et al26 found that self-reported adherence remarkably improved in participants who received intensive education, consultation services, and repeated reminders, while unchanged adherence levels were reported in the non-intervention cohort.…”

Section: Discussionmentioning

confidence: 99%

The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy

AlAjmi¹,

Al-Aqeel²,

Baz³

2017

PPA

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Purpose To evaluate the effectiveness of a pharmacist-led educational interview in terms of adherence to antiepileptic drug administration among adult patients with epilepsy. Method Sixty adult patients with epilepsy who fulfilled the inclusion criteria were recruited. A pharmacist-led educational interview was conducted with the intervention group (n=30). Patients in the control group (n=30) were interviewed and contacted 6 weeks after the initial visit without receiving any intervention. Antiepileptic drug adherence was measured during clinic visits, and 6 weeks afterwards using the 8-item Morisky Medication Adherence Scale. This prospective interventional study was conducted between September and December 2013. Results Only 29 control patients and 27 intervention patients completed the 6 weeks post-intervention adherence measurement. The adherence score average in the intervention group was 5.26±0.98 at baseline and improved to 6.7±0.823 ( P <0.0001) after intervention. In the control group, the adherence score average was 5.76±1.806 at baseline and 5.83±1.627 at 6 weeks ( P =0.792). While there was no statistically significant difference in adherence score between intervention and control groups at baseline, the post-intervention difference was significant ( P =0.024). Conclusion Our study suggests that pharmacist-led educational interviews had a positive impact on medication adherence in patients with epilepsy.

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Strategies for improving adherence to antiepileptic drug treatment in people with epilepsy

Abstract: References to other published versions of this review Al-aqeel 2010 Sinaa Al-aqeel, Jawza Al-sabhan. Strategies for improving adherence to antiepileptic drug treatment in patients with epilepsy. Cochrane Database of Systematic Reviews 2010, Issue 1.

Cited by 42 publications

References 57 publications

ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

Correction of medication nonadherence results in better seizure outcomes than dose escalation in a novel preclinical epilepsy model of adherence

The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy

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