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Adherence to antiepileptic medicines in children: a multiple-methods assessment involving dried blood spot sampling

Noraida Mohamed Shah1, Ahmed F Hawwa, Jeff S Millership

  • 1Clinical and Practice Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, Belfast, United Kingdom.

Epilepsia
|March 2, 2013
PubMed

Insights

Adherence to antiepileptic drugs (AEDs) in children with epilepsy was assessed using multiple methods. Nonadherence was observed in 33% of children, with generalized epilepsy and parental depressed mood being significant predictors.

Area of Science:

  • Pediatric Neurology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Epilepsy affects a significant number of children worldwide.
  • Adherence to antiepileptic drugs (AEDs) is crucial for effective seizure management.
  • Accurate assessment of AED adherence in pediatric populations remains challenging.

Purpose of the Study:

  • To evaluate antiepileptic drug (AED) adherence in children with epilepsy.
  • To compare multiple adherence assessment methods, including novel dried blood spot (DBS) analysis.
  • To identify factors associated with nonadherence in pediatric epilepsy.

Main Methods:

  • A cohort of 100 children (≤17 years) with epilepsy was studied.
  • Adherence was measured via self-reporting, prescription refills, and AED concentrations in dried blood spot (DBS) samples.
  • Population pharmacokinetic modeling was used for DBS analysis; nonadherence was defined by any method indicating poor adherence.

Main Results:

  • The overall rate of nonadherence to AEDs was 33% in the studied children.
  • Children with generalized epilepsy (OR 4.7) and those with parental depressed mood (OR 3.6) were significantly more likely to be nonadherent.
  • Parental and child self-reporting, GP refill data, and DBS concentrations were utilized for adherence determination.

Conclusions:

  • This study introduces a novel methodology using clinic and home-based DBS samples for AED adherence assessment in children.
  • Dried blood spot (DBS) analysis, when further developed and combined with other methods, shows promise for adherence monitoring.
  • Seizure type and parental mental health (depressed mood) are significant predictors of medication nonadherence in pediatric epilepsy.
Abstract

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