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癫痫患者的抗癫痫药物不依从性及其预测因素

Antiepileptic Drug Nonadherence and Its Predictors among People with Epilepsy.

作者信息

Getnet Asmamaw, Woldeyohannes Solomon Meseret, Bekana Lulu, Mekonen Tesfa, Fekadu Wubalem, Menberu Melak, Yimer Solomon, Assaye Adisu, Belete Amsalu, Belete Habte

机构信息

Finote Selam Hospital, Finote Selam, Ethiopia.

Diseases Prevention and Control, School of Public Health, University of Queensland, Brisbane, QLD, Australia.

出版信息

Behav Neurol. 2016;2016:3189108. doi: 10.1155/2016/3189108. Epub 2016 Dec 8.

Abstract

Antiepileptic drugs are effective in the treatment of epilepsy to the extent that about 70% of people with epilepsy can be seizure-free, but poor adherence to medication is major problem to sustained remission and functional restoration. The aim of this study was to assess the prevalence and associated factors of antiepileptic drug nonadherence. Cross-sectional study was conducted on 450 individuals who were selected by systematic random sampling method. Antiepileptic drug nonadherence was measured by Morisky Medication Adherence Scale (MMAS) and logistic regression was used to look for significant associations. The prevalence of AEDs nonadherence was 37.8%. Being on treatment for 6 years and above [AOR = 3.47, 95% CI: 1.88, 6.40], payment for AEDs [AOR = 2.76, 95% CI: 1.73, 4.42], lack of health information [AOR = 2.20, 95% CI: 1.41,3.43], poor social support [AOR = 1.88, 95%, CI: 1.01, 3.50], perceived stigma [AOR = 2.27, 95% CI: 1.45, 3.56], and experience side effect [AOR = 1.70, 95% CI: 1.06, 2.72] were significantly associated with antiepileptic drug nonadherence. More than one-third of people with epilepsy were not compliant with their AEDs. Giving health information about epilepsy and its management and consequent reduction in stigma will help for medication adherence.

摘要

抗癫痫药物在治疗癫痫方面有一定效果,约70%的癫痫患者可实现无癫痫发作,但药物依从性差是实现持续缓解和功能恢复的主要问题。本研究旨在评估抗癫痫药物不依从的患病率及相关因素。采用系统随机抽样方法选取450名个体进行横断面研究。通过Morisky药物依从性量表(MMAS)测量抗癫痫药物不依从情况,并使用逻辑回归寻找显著关联。抗癫痫药物不依从的患病率为37.8%。接受治疗6年及以上[AOR = 3.47,95%CI:1.88,6.40]、抗癫痫药物费用支付情况[AOR = 2.76,95%CI:1.73,4.42]、缺乏健康信息[AOR = 2.20,95%CI:1.41,3.43]、社会支持差[AOR = 1.88,95%CI:1.01,3.50]、感知到耻辱感[AOR = 2.27,95%CI:1.45,3.56]以及经历副作用[AOR = 1.70,95%CI:1.06,2.72]均与抗癫痫药物不依从显著相关。超过三分之一的癫痫患者未遵医嘱服用抗癫痫药物。提供有关癫痫及其管理的健康信息并进而减少耻辱感将有助于提高药物依从性。

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