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One-month adherence in children with new-onset epilepsy: white-coat compliance does not occur

Avani C Modi1, Diego A Morita, Tracy A Glauser

  • 1Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Adherence and Self Management, MLC-3015, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA. avani.modi@cchmc.org

Pediatrics
|March 5, 2008
PubMed

Insights

First-month antiepileptic drug adherence in children with new-onset epilepsy was 79.4%, influenced by parental marital status and socioeconomic status. Adherence did not improve near clinic visits, highlighting a concern for effective epilepsy treatment.

Area of Science:

  • Pediatric Neurology
  • Pharmacology
  • Epilepsy Management

Background:

  • Adherence to antiepileptic drug (AED) therapy is crucial for managing epilepsy effectively.
  • Understanding adherence patterns in new-onset epilepsy is essential for optimizing treatment outcomes.
  • Objective measurement of adherence provides reliable data for clinical research.

Purpose of the Study:

  • To document adherence patterns during the first month of AED therapy in children with new-onset epilepsy.
  • To investigate the influence of demographic and epilepsy-related variables on adherence.
  • To assess if adherence improves before or after clinic visits ('white-coat compliance').

Main Methods:

  • Electronic monitoring using Medication Event Monitoring System TrackCap for 35 children with new-onset epilepsy.
  • Adherence calculated over the first month and around clinic appointments (1, 3, 5 days before; 3 days after).
  • Analysis of adherence in relation to child's age, gender, epilepsy type, and socioeconomic factors.

Main Results:

  • Overall one-month adherence was 79.4% in children with new-onset epilepsy.
  • Higher adherence was observed in children with married parents and higher socioeconomic status.
  • Adherence did not correlate with gender, age, epilepsy type, medication, or seizure frequency. No 'white-coat compliance' effect was detected.

Conclusions:

  • Poor initial adherence to AEDs in children with new-onset epilepsy is a significant concern.
  • Demographic factors, not proximity to clinic visits, influence adherence.
  • Further longitudinal studies are needed to assess the long-term impact of adherence on epilepsy management.
Abstract

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