Santiago-Rodríguez Efraín, Sales-Carmona Víctor, Ramos-Ramírez Ricardo
Unidad de Neurología Hospital General de México, SSa.
Gac Med Mex. 2002 May-Jun;138(3):241-6.
Inadequate compliance is a major contributor to unsuccessful treatment in epilepsies. To establish risk factors associated with therapeutic non-compliance in patients with epilepsy, we carried out a case-control study, nested into a cohort, with thirteen factors possibly implicated in therapeutic non-compliance. The patient's general characteristics, the illness, and patient-practitioner relationship were studied. Patients were followed during 6 months; during this time, serum levels and pill counts were registered. Of 150 patients, 66 were non-compliers and 84 were compliers. Seven of thirteen factors were statistically different with an odds ratio greater than 3 (p < 0.05). However, after log-lineal regression analysis, only the total number of pills per day and the subject's intellectual level were significant. These two factors increase 3.66 times the risk of non-compliance. We conclude that epileptic patients with a low intellectual level and more than three prescribed pills per day have a 3.66 times greater risk of non-compliance to anti epileptic treatment.
依从性不足是癫痫治疗失败的主要原因之一。为了确定癫痫患者治疗不依从的相关危险因素，我们进行了一项嵌套在队列研究中的病例对照研究，涉及13个可能与治疗不依从有关的因素。我们研究了患者的一般特征、病情以及患者与医生的关系。对患者进行了6个月的随访；在此期间，记录了血清水平和药片计数。150名患者中，66名不依从，84名依从。13个因素中有7个在统计学上有差异，比值比大于3（p<0.05）。然而，经过对数线性回归分析，只有每日药片总数和患者的智力水平具有显著性。这两个因素使不依从风险增加3.66倍。我们得出结论，智力水平低且每天服用超过三种处方药的癫痫患者，抗癫痫治疗不依从的风险要高3.66倍。
