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Demystifying a family-based epilepsy adherence problem-solving intervention: Exploring adherence barriers and

Desireé N Williford1, Shanna M Guilfoyle1,2, Avani C Modi1,2

  • 1Cincinnati Children's Hospital Medical Center.

Clinical Practice in Pediatric Psychology
|March 27, 2023
PubMed

Insights

Families identified forgetting medication and routine changes as key barriers to adherence in pediatric epilepsy. Environmental cuing and positive reinforcement were common solutions, improving medication management for children.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacy
  • Behavioral Science

Background:

  • Medication adherence is crucial for managing pediatric epilepsy, yet significant barriers exist, impacting seizure control and quality of life.
  • Nonadherence in children with epilepsy is a common challenge for healthcare providers and families.
  • A tailored intervention was developed to address these specific adherence barriers.

Purpose of the Study:

  • To identify the primary barriers to medication adherence encountered by families of children with epilepsy.
  • To document the solutions families implemented to overcome these identified adherence challenges.
  • To inform clinical practice regarding effective adherence strategies in pediatric epilepsy management.

Main Methods:

  • A randomized controlled trial was conducted with young children (2-12 years) diagnosed with epilepsy and demonstrating nonadherence.
  • Participants in the treatment group received a manualized, family-tailored education and problem-solving intervention.
  • Adherence barriers and solutions were independently coded using thematic analysis from intervention session data.

Main Results:

  • The most frequent adherence barriers reported were Overall Forgetting (38-57%) and Routine Change Routine (14-24%).
  • Other identified barriers included Competing Activities, Opposition, and Running Out of Medication.
  • Families implemented solutions such as Environmental Cuing (29-50%), Positive Reinforcement (14-23%), and Multi-Pronged solutions.

Conclusions:

  • This study highlights significant adherence barriers and effective solutions identified by families managing pediatric epilepsy.
  • Findings offer practical guidance for healthcare teams to address medication adherence challenges in clinical settings.
  • The results underscore the importance of family-centered approaches in improving adherence for children with epilepsy.
Abstract

Keywords:
childrencomplianceforgettingqualitativeseizures

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