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Treatment non-adherence in pseudo-refractory epilepsy
Eylert Brodtkorb1, Christian Samsonsen2, Janne Kutschera Sund3
1Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Epilepsy Research
|February 22, 2016
Summary
Non-adherence to antiepileptic drugs significantly impacts epilepsy outcomes. Tailoring interventions to individual non-adherence patterns is crucial for effective patient management and improved seizure control.
Area of Science:
- Neurology
- Pharmacology
- Behavioral Science
Background:
- Non-adherence to antiepileptic drugs (AEDs) is a significant, often unrecognized, factor affecting epilepsy outcomes.
- Understanding medication-taking behavior is essential for managing epilepsy effectively.
Purpose of the Study:
- To review current knowledge on medication-taking behavior in people with epilepsy.
- To highlight the importance of individualized interventions for non-adherence.
Main Methods:
- Review of existing literature on AED adherence and non-adherence.
- Categorization of non-adherence patterns (non-initiation, poor execution, non-persistence).
- Discussion of various adherence assessment methods and their limitations.
Main Results:
- Non-adherence is linked to clinical characteristics, healthcare barriers, polytherapy, side effects, cost, depression, and caregiver education.
- Young adults with generalized epilepsy are particularly vulnerable.
- Assessment methods for adherence have limitations; therapeutic drug monitoring is direct but requires consideration of variability.
Conclusions:
- Non-adherence to AEDs leads to seizure breakthrough, hospitalizations, status epilepticus, and potentially sudden unexpected death in epilepsy (SUDEP).
- Management requires identifying individual causes of non-adherence and implementing multiprofessional interventions.
- Increased clinical and scientific attention is needed for AED non-adherence.
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