Department of Pharmacology and Toxicology, College of Pharmacy, An-Najah National University, Nablus, Palestine.
Epilepsy Behav. 2011 Jul;21(3):301-5. doi: 10.1016/j.yebeh.2011.04.011. Epub 2011 May 14.
Reports about medication adherence and satisfaction in patients with epilepsy in Arab countries are lacking. The objective of this study was to assess medication adherence and its relationship with treatment satisfaction, number of antiepileptic drugs (AEDs) taken, and epilepsy control in a sample of Palestinian patients.
This cross-sectional descriptive study was carried out at Al-Makhfya Governmental Outpatient Center in Nablus, Palestine, during the summer of 2010. A convenience sampling method was used to select patients over the study period. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS); treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Epilepsy was arbitrarily defined as "well controlled" if the patient had had no seizures in the last 3 months and was defined as "poorly controlled" if he or she had had at least one seizure in the last 3 months.
A convenience sample of 75 patients was studied. On the basis of the MMAS, 11 patients (14.7%) had a low rate, 37 (49.3%) had a medium rate, and 27 (36%) had a high rate of adherence. Adherence was positively and significantly correlated with age (P=0.02) and duration of illness (P=0.01). No significant difference in adherence was found between patients with well-controlled and those with poorly controlled epilepsy. Similarly, there was no significant difference in adherence between patients on monotherapy and those on polytherapy. Mean satisfaction with respect to effectiveness, side effects, convenience, and global satisfaction were 73.6±20.7, 82.4±29.8, 69.5±15.5, and 68.4±18.3, respectively. There were significant differences in mean values in the effectiveness (P<0.01) and convenience (P<0.01) domains, but not the side effect (P=0.1) and global satisfaction (P=0.08) domains among patients with different levels of adherence. Patients on monotherapy had significantly higher satisfaction in the effectiveness domain (P=0.04) than patients on polytherapy. Similarly, patients with well-controlled epilepsy scored significantly higher in the Effectiveness (P=0.01) and Global Satisfaction (P=0.01) domains than those with poorly controlled epilepsy.
In our convenience sample, we found that adherence to and satisfaction with AEDs were moderate and were not associated with seizure control or number of AEDs.
在阿拉伯国家，有关癫痫患者用药依从性和满意度的报告十分匮乏。本研究的目的是评估巴勒斯坦患者样本中的用药依从性及其与治疗满意度、服用抗癫痫药物（AED）的数量和癫痫控制之间的关系。
这是一项在巴勒斯坦纳布卢斯的马赫菲亚政府门诊中心于 2010 年夏季进行的横断面描述性研究。在研究期间，采用便利抽样法选择患者。用药依从性采用 Morisky 用药依从性量表（MMAS）的 8 项进行测量；治疗满意度采用治疗满意度问卷（TSQM 1.4）进行测量。如果患者在过去 3 个月内无发作，则将癫痫定义为“控制良好”；如果患者在过去 3 个月内至少有一次发作，则将癫痫定义为“控制不佳”。
对 75 例便利样本进行了研究。根据 MMAS，11 例（14.7%）患者的依从性低，37 例（49.3%）患者的依从性中等，27 例（36%）患者的依从性高。依从性与年龄（P=0.02）和病程（P=0.01）呈正相关且有统计学意义。控制良好的患者和控制不佳的患者之间的依从性没有显著差异。同样，单药治疗和多药治疗的患者之间的依从性也没有显著差异。关于有效性、副作用、便利性和总体满意度的平均满意度分别为 73.6±20.7、82.4±29.8、69.5±15.5 和 68.4±18.3。在有效性（P<0.01）和便利性（P<0.01）领域的平均值存在显著差异，但在副作用（P=0.1）和总体满意度（P=0.08）领域没有显著差异。依从性水平不同的患者在有效性（P=0.04）方面的满意度显著高于多药治疗的患者。同样，控制良好的癫痫患者在有效性（P=0.01）和总体满意度（P=0.01）方面的评分明显高于控制不佳的癫痫患者。
在我们的便利样本中，我们发现 AED 的依从性和满意度处于中等水平，与癫痫发作控制或 AED 数量无关。
