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Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy

机译：抗癫痫药副作用与癫痫患者报告的药物依从性之间的关联

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Background and aim: Adherence to treatment is a critical component of epilepsy management. This study examines whether addressing antiepileptic drug (AED) side effects at every visit is associated with increased patient-reported medication adherence. Patients and methods: This study identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits over a 3-year period. Demographic and clinical characteristics were abstracted. Evidence that AED side effects were addressed was measured through 1) phone interview (patient-reported) and 2) medical records abstraction (physician-documented). Medication adherence was assessed using the validated Morisky Medication Adherence Scale-4. Complete adherence was determined as answering “no” to all questions. Results: Sixty-two (25%) patients completed the interviews. Participants and nonparticipants were comparable with respect to demographic and clinical characteristics; however, a smaller proportion of participants had a history of drug-resistant epilepsy than nonparticipants (17.7% vs 30.9%, P =0.04). Among the participants, evidence that AED side effects were addressed was present in 48 (77%) medical records and reported by 51 (82%) patients. Twenty-eight (45%) patients reported complete medication adherence. The most common reason for incomplete adherence was missed medication due to forgetfulness (n=31, 91%). There was no association between addressing AED side effects (neither physician-documented nor patient-reported) and complete medication adherence ( P =0.22 and 0.20). Discussion and conclusion: Among patients with epilepsy, addressing medication side effects at every visit does not appear to increase patient-reported medication adherence.
机译：背景与目的：坚持治疗是癫痫治疗的重要组成部分。这项研究检查了每次就诊抗癫痫药物（AED）的副作用是否与患者报告的依从性增加有关。患者和方法：本研究确定了243名患有癫痫的成年人，他们在两次学术门诊神经科就诊时就诊，并在3年​​内至少两次就诊。人口和临床特征被抽象。 AED副作用得到解决的证据是通过1）电话访谈（患者报告）和2）病历摘要（医师记录）来衡量的。使用经过验证的Morisky药物依从性量表4评估药物依从性。完全遵守被确定为对所有问题回答“否”。结果：62（25％）位患者完成了访谈。参与者和非参与者在人口统计学和临床​​特征方面具有可比性;但是，与非参与者相比，具有抗药性癫痫病史的参与者比例较小（分别为17.7％和30.9％，P = 0.04）。在参与者中，有48位（77％）的病历中存在解决AED副作用的证据，有51位（82％）的患者报告了这一现象。二十八（45％）名患者报告完全服药。不完全依从的最常见原因是由于健忘而错过药物治疗（n = 31，91％）。解决AED副作用（既无医生记录也无患者报告）与完全依从性之间没有关联（P = 0.22和0.20）。讨论和结论：在癫痫患者中，解决每次就诊的药物副作用似乎并未增加患者报告的药物依从性。

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