Medication adherence and seizures: An assessment among patients receiving tertiary treatment and their opinions about what's helpful

INTRODUCTION: The purpose of this study was to investigate the relationship between antiepileptic drug adherence (AED) and seizures among patients receiving care at a tertiary epilepsy center and to assess their recommended strategies for improvement. Research suggests that even among patients that take their AEDs, few are 100% compliant. Failure to comply puts patients at increased risk for further seizures. As a public health issue, medication adherence and chronic conditions in vulnerable populations needs further attention.

METHOD: A mailed survey was used to examine AED adherence and seizures among patients receiving care at a tertiary epilepsy center. Survey items included questions about medication dosing, possibility of seizures occurring after omitted doses, barriers, demographics, and strategies for change. SPSS 20.0 was used to analyze the data.

RESULTS: The sample was 180 participants (37% response rate). The majority reported taking AED twice a day. About 29% (n=53) reported they never missed a dose of medication. About 68% (n=122) reported they have forgotten, missed or skipped a dose of their AED, with “forgetting” being the main reason (n=120; 67%). A third (33%; n=59) indicated that on average they missed a dose of medication once per month. Also 33% said they experienced seizures when they missed a dose.

DISCUSSION: Findings indicated that even among those that receive the most specialized epileptic care, that AED adherence and adverse outcomes are still problematic. The patients' recommended strategies for improving adherence are outlined. Implications for public health research and clinical applications are described.