São Camilo University Center, São Paulo, Brazil.
Seizure. 2013 Jun;22(5):384-9. doi: 10.1016/j.seizure.2013.02.006. Epub 2013 Mar 9.
To investigate factors associated with treatment non-adherence in Brazilian patients with epilepsy.
Prospective cross-sectional study. We evaluated 385 epilepsy outpatients in a tertiary referral center, 18 years or older, literate, without cognitive impairment or active psychiatric disorders, who were independent in daily living activities. Data were analyzed with correlation tests and conjoint analysis using multivariate logistic regression.
Non-adherence rate, measured by the Morisky-Green Test, was 66.2%, a moderate-to-low adherence level. Non-adherence was higher in men, in younger patients and in patients with uncontrolled seizures. Increasing treatment complexity was also associated with decreased treatment adherence.
Strategies designed to improve treatment adherence should address peculiarities associated with younger ages and male gender. Physicians should be made aware that prescription of less complex treatment regimens may result in better treatment adherence, and, therefore, better seizure control. The challenge in adjusting AED treatment in this population is to minimize treatment complexity, thus increasing chances for treatment adherence.
调查与巴西癫痫患者治疗不依从相关的因素。
前瞻性横断面研究。我们评估了一家三级转诊中心的 385 名癫痫门诊患者,年龄在 18 岁及以上,识字,无认知障碍或活跃的精神疾病,日常生活活动独立。使用相关检验和多元逻辑回归联合分析对数据进行分析。
Morisky-Green 测试测量的不依从率为 66.2%,属于中低水平的依从。男性、年轻患者和未控制的癫痫发作患者的不依从率更高。治疗复杂性的增加也与治疗依从性降低相关。
旨在提高治疗依从性的策略应针对与年龄较小和男性性别相关的特点。医生应该意识到,开处方时选择不太复杂的治疗方案可能会导致更好的治疗依从性,从而更好地控制癫痫发作。在调整该人群的 AED 治疗时,面临的挑战是最小化治疗复杂性,从而增加治疗依从性的机会。