Document Type : Original Article
Authors
1 Department of Pediatric Neurology, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Colorectal Research Center, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract
Background: A wide range of adherence to the use of anti-seizure medications has been reported among children with the disease, and accordingly, various factors on the degree of adherence to the drug have been reported. But in our society, there is no clear picture of drug adherence and related factors among children with seizures. We evaluated the frequency of adherence to anti-seizure medication as well as related factors.
Methods: This cross-sectional study was conducted on 120 children with epilepsy who referred to Ali Asghar Hospital in Tehran, Iran, during 2019 and 2020. Along with demographic characteristics, adherence to antiepileptic medications was assessed by the Modified Morisky Medication Adherence Scale [E1] (MMAS).
Results: The overall frequency of adherence to anti-seizure medications among children was reported to be about 41.7%. Among all baseline characteristics, much higher adherence was revealed in patients with educated parents. The rate of drug adherence in children with a history of perinatal morbidities was much lower than in other patients. The type of seizure could also affect the rate of drug adherence as the highest and the lowest adherence was found concerning focal impaired awareness seizure (57.1%) and atonic seizures (11.1%) indicating a significant difference (P = 0.022). The most common causes of non-adherence to treatment were expressing inability to treat the patient (23.0%), parents’ forgetfulness to give medicine to the child (18.3%), and not taking medication when traveling or leaving home (16.7%).
Conclusion: The lower level of education of the parents, type of seizure, as well as the presence of underlying perinatal morbidity in the child can predict non-compliance with anticonvulsant medication regimens among affected children.
Keywords
- Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: A practical clinical definition of epilepsy. Epilepsia 2014; 55(4): 475-82.
- Ito H. What should we do to improve patients' adherence? J Exp Clin Med 2013; 5(4): 127-30.
- Baker GA, Jacoby A, Gorry J, Doughty J, Ellina V. Quality of life of people with epilepsy in Iran, the Gulf, and Near East. Epilepsia 2005; 46(1): 132-40.
- Asadi-Pooya AA. Drug compliance of children and adolescents with epilepsy. Seizure 2005; 14(6): 393-5.
- Ashktorab T, Yadollahi S, Safavi Bayat Z, Zayery F. The correlation between self-management behaviors and drug adherence among people with epilepsy in Iran Epilepsy Association. Avicenna J Nurs Midwifery Care 2013; 21(2): 5-15. [In Persian].
- O'Brien MK, Petrie K, Raeburn J. Adherence to medication regimens: Updating a complex medical issue. Med Care Rev 1992; 49(4): 435-54.
- Dunbar-Jacob J, Mortimer-Stephens MK. Treatment adherence in chronic disease. J Clin Epidemiol 2001; 54(Suppl 1): S57-S60.
- Davis KL, Candrilli SD, Edin HM. Prevalence and cost of nonadherence with antiepileptic drugs in an adult managed care population. Epilepsia 2008; 49(3): 446-54.
- Faught E, Duh MS, Weiner JR, Guerin A, Cunnington MC. Nonadherence to antiepileptic drugs and increased mortality: Findings from the RANSOM Study. Neurology 2008; 71(20): 1572-8.
- Kazemi Majd R, Hosseini M, Safi MH, Norouzi K, Hosseinzadeh S. The effect of self-care education based on short message service on self-efficacy and adherence to the medication regimen in adolescents with epilepsy referred to Iran Epilepsy Association in 2016. J Nurs Edu 2017; 6(4): 48-55. [In Persian].
- Yadegary MA, Dehghan-Naeyeri N, Ali-asgharpoor M, Naseh L. The effect of educational program on drugs self-management in patient with epilepsy- A randomized clinical trial. J Clin Nurs Midwifery 2013; 2(3): 86-94. [In Persian].
- Al-Qasem A, Smith F, Clifford S. Adherence to medication among chronic patients in Middle Eastern countries: Review of studies. East Mediterr Health J 2011; 17(4): 356-63.
- Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
- Yang C, Yu D, Li J, Zhang L. Prevalence of medication adherence and factors influencing adherence to antiepileptic drugs in children with epilepsy from western China: A cross-sectional survey. Epilepsy Behav 2020; 104(Pt A): 106662.
- Shetty J, Greene SA, Mesalles-Naranjo O, Kirkpatrick M. Adherence to antiepileptic drugs in children with epilepsy in a Scottish population cohort. Dev Med Child Neurol 2016; 58(5): 469-74.
- Modi AC, Morita DA, Glauser TA. One-month adherence in children with new-onset epilepsy: white-coat compliance does not occur. Pediatrics 2008; 121(4): e961-e966.
- Jacob L, Hamer HM, Kostev K. Adherence to antiepileptic drugs in children and adolescents: A retrospective study in primary care settings in Germany. Epilepsy Behav 2017; 75: 36-41.
- Yang C, Hao Z, Yu D, Xu Q, Zhang L. The prevalence rates of medication adherence and factors influencing adherence to antiepileptic drugs in children with epilepsy: A systematic review and meta analysis. Epilepsy Res 2018; 142: 88-99.
- Nazziwa R, Mwesige AK, Obua C, Ssenkusu JM, Mworozi E. Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting. Pan Afr Med J 2014; 17: 44.
- Lee YK, Ah YM, Choi YJ, Cho YS, Kim KJ, Lee JY. Antiepileptic drug adherence and persistence in children with epilepsy attending a large tertiary care children's hospital. Epileptic Disord 2016; 18(4): 408-17.
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