Hodges Joseph C, Treadwell Janet, Malphrus Amy D, Tran Xuan G, Giardino Angelo P
Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street No. 1250, Houston, TX 77030, USA ; University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
Texas Children's Health Plan, 2450 Holcombe Boulevard, Suite 34L, Houston, TX 77021, USA.
ISRN Pediatr. 2014 Feb 19;2014:734689. doi: 10.1155/2014/734689. eCollection 2014.
Background. Antiepileptic drugs (AEDs) noncompliance is associated with increased risk of seizures and morbidity in seizure disorder patients. Objective. To identify risk factors that correlated to higher levels of morbidity, measured by emergency room (ER) utilization by seizure disorder members taking AED. Methods. Patients with primary or secondary diagnosis of seizures, convulsions, and/or epilepsy and prescribed AEDs during an 11-month period were included in the study. Variables were analyzed using multivariate statistical analysis including logistic regression. Results. The study identified 201 members. No statistical significance (NS) between age, gender, number of tablets, type of drug, or other risk factors was associated with increased mortality. Statistical significance resulted with medication compliance review of 0-14 days, 15-60 days, and 61+ days between refills. 68% of patients with ER visit had noncompliance refill between 0 and 14 days compared to 52% of patients in non-ER group (P = 0.04). Contrastingly, 15% of ER group had refills within 15-60 days compared with 33% of non-ER group (P = 0.01). There was NS difference between two groups when noncompliance was greater than 60 days (P = 0.66). Conclusions. The study suggests that careful monitoring of pharmaceutical refill information could be used to identify AED noncompliance in epileptic patients.
背景。癫痫患者不遵医嘱服用抗癫痫药物（AEDs）会增加癫痫发作风险及发病率。目的。确定与较高发病率相关的风险因素，通过服用AED的癫痫患者使用急诊室（ER）的情况来衡量发病率。方法。研究纳入在11个月期间有癫痫、惊厥和/或癫痫的原发性或继发性诊断且开具了AEDs的患者。使用包括逻辑回归在内的多变量统计分析对变量进行分析。结果。该研究确定了201名成员。年龄、性别、药片数量、药物类型或其他风险因素与死亡率增加之间无统计学意义（NS）。在两次取药之间的0 - 14天、15 - 60天和61天以上的用药依从性审查中出现了统计学意义。68%的急诊就诊患者在0至14天之间有不遵医嘱取药情况，而非急诊组为52%（P = 0.04）。相反，15%的急诊组患者在15 - 60天内取药，而非急诊组为33%（P = 0.01）。当不遵医嘱情况大于60天时，两组之间无显著差异（P = 0.66）。结论。该研究表明，仔细监测药物取药信息可用于识别癫痫患者的AED不遵医嘱情况。
