Factors influencing medication adherence after epilepsy surgery.

AIM

In drug-responsive epilepsy patients, treatment non-compliance is a major factor in seizure recurrence, but adherence to prescribed regimens following epilepsy surgery has not been examined. We measured adherence to prescribed antiepileptic drugs (AEDs) after epilepsy surgery and investigated factors influencing treatment non-compliance.

METHODS

Postsurgical epilepsy patients (n=214) were monitored for 18.1±8.1 months. Adherence was measured using the Medication Possession Ratio (MPR) self-report questionnaire, with MPR<0.8 defined as non-adherence.

RESULTS

According to the MPR, 58 patients (27.1%) were non-adherent after surgery. There were no differences in demographic and clinical variables, such as age (p=0.057, t=-1.925), duration of illness (p=0.597, t=0.530), gender ratio (p=0.714, χ2=0.134), and place of residence (urban vs. rural; p=0.874, χ2=0.025), between adherent and non-adherent patients. Moreover, adherence was not related to surgical outcome as evaluated by the Engel classification (p=0.635, χ2=1.628) or to the types of AEDs after surgery (p=0.165, χ2=6.530). The most common reasons for non-adherence were seizure-free status for an extended period (26.5%), forgetfulness (19.1%), and an inability to buy the drugs locally (18.6%).

CONCLUSION

Adherence to AEDs is improved after epilepsy surgery compared to presurgical estimates, but is still a common and serious problem. Targeted postsurgical management programs and communication strategies are necessary to improve adherence to AEDs after epilepsy surgery.