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Compliance with appointment and medications in a pediatric neurology clinic at a University Hospital in Riyadh, Saudi
Eiad A Al-Faris1, Hamza M Abdulghani, Awad H Mahdi
1Department of Family & Community Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Insights
Pediatric epilepsy patients show lower appointment compliance (53%) than medication compliance (86%). Non-adherence to appointments, often due to registration errors or forgetfulness, indicates poor medication adherence. Telephone calls can improve attendance.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacy
- Health Services Research
Background:
- Epilepsy management in children requires consistent medication adherence and regular clinic appointments.
- Non-compliance with treatment regimens poses a significant challenge in pediatric epilepsy care.
- Understanding factors influencing adherence is crucial for optimizing therapeutic outcomes.
Purpose of the Study:
- To estimate the rate of appointment and medication compliance in pediatric epilepsy patients.
- To identify factors associated with non-compliance in this population.
- To determine parents' perceived reasons for non-compliance with clinic appointments.
Main Methods:
- Prospective study including 147 epileptic children over 12 months.
- Parental interviews using questionnaires for compliance assessment.
- Prospective monitoring of appointment adherence and medication compliance.
- Telephone follow-up for 70 non-attending patients to ascertain reasons for non-attendance.
Main Results:
- Medication compliance was reported at 86%, while appointment compliance was 53%.
- Appointment compliance was positively correlated with medication compliance.
- Factors influencing non-compliance included medication side effects, parental dissatisfaction, belief in alternative medicine, and perceived low susceptibility.
- Primary reasons for non-attendance were wrongly registered appointments (27.5%) and forgetfulness (22.5%).
Conclusions:
- Failure to attend clinic appointments is a marker for poor medication compliance in pediatric epilepsy.
- Interventions such as telephone calls are recommended to improve clinic attendance.
- Utilizing health belief model questionnaires can help tailor health education for individual patients and families.
Objective:
The objectives of the study are to estimate the rate of epileptic patients` compliance with appointments and medications in a pediatric neurology clinic. Also to study the factors associated with non-compliance and to determine the parents` perceived reasons for non-compliance with appointments.
Methods:
It is a prospective study in which 147 epileptic children who attended the neurology clinic during the first 12-months of the study period were included. Patients were recruited into the study after their parents were interviewed using a detailed questionnaire; their compliance with appointments was monitored prospectively over at least a one year from their recruitment into the study. The parents of the other 70 patients who did not attend the clinic were telephoned. Only 32 replied and were asked about the reasons for non-attendance to the clinic.
Results:
Eighty-six percent of the patients` parents stated that they were complying with the medications while only 53% of them did not miss any appointment to the clinic during the study period. Compliers with appointments were more likely to comply with their medications too. Children with grand-mal epilepsy and absence seizures were found to be more likely to comply with taking medications than patients with febrile, rolandic and myoclonic seizures (P=0.01). Health belief model factors associated with non-compliance were 1. Children encountering side effects from their medications 2. Parents who were not satisfied with the provided services 3. Parents who thought that alternative medicine is more effective than traditional medicine 4. Parents who think that their children are not susceptible. Patients` perceived main reasons for non-compliance were wrongly registered appointments (27.5%), forgetfulness (22.5%) and busy parents.
Conclusion:
Failure to keep the clinic appointment is an indicator of poor compliance with medications. A telephone call is recommended to reduce the role of clinic non-compliance. Developing a questionnaire form to investigate parents health belief model could be used routinely by social workers and then health education could be tailored for each patient and parent.
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