Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Acta Neurol Scand. 2018 Nov;138(5):417-424. doi: 10.1111/ane.12994. Epub 2018 Jul 9.
The primary objective of present study was to observe the effect of providing SUDEP (Sudden Unexpected Death in Epilepsy) information on drug adherence in persons with epilepsy (PWE). We also looked at impact of disclosing SUDEP information on patient's quality of life and mood.
This prospective study had a pretest/post-test design. A total of 231 consecutive PWE (>15 years) were enrolled. Of these 121 PWE received information about SUDEP in addition to standard epilepsy care. One hundred and ten PWE (control group) received routine standard epilepsy care but did not receive SUDEP information. Follow up assessment was done at 6 months. The primary outcome was a change in drug adherence (measured by Modified Morisky Medication Adherence Scale, MMAS) in PWE following disclosure of SUDEP information.
After 6 months, 116 PWE in the SUDEP information group and 106 in control group were available for follow up. A non-significant higher adherence was observed in the SUDEP information group as compared to the control group (Mean MMAS change 0.51 ± 1.66 vs 0.25 ± 1.26, P value = 0.194). No significant change was perceived in patient's anxiety and depression levels or quality of life in either group.
The present study suggests that providing information on SUDEP to PWE and their caregivers may increase drug adherence without adverse effect on quality of life or mood. Well-designed studies with high methodological quality are required to determine the precise effect size associated with disclosure of SUDEP information on drug adherence in PWE.
本研究的主要目的是观察提供癫痫猝死(SUDEP)信息对癫痫患者(PWE)药物依从性的影响。我们还研究了披露 SUDEP 信息对患者生活质量和情绪的影响。
这是一项前瞻性研究,采用了预测试/后测试设计。共纳入 231 名连续的 PWE(>15 岁)。其中 121 名 PWE 除了接受标准癫痫护理外,还接受了 SUDEP 信息。110 名 PWE(对照组)接受常规标准癫痫护理,但未接受 SUDEP 信息。在 6 个月时进行随访评估。主要结果是在披露 SUDEP 信息后 PWE 的药物依从性(通过改良 Morisky 药物依从性量表(MMAS)测量)的变化。
6 个月后,SUDEP 信息组有 116 名 PWE 和对照组有 106 名 PWE 可进行随访。与对照组相比,SUDEP 信息组的依从性有显著提高(Mean MMAS change 0.51 ± 1.66 vs 0.25 ± 1.26,P value = 0.194)。两组患者的焦虑和抑郁水平或生活质量均无明显变化。
本研究表明,向 PWE 及其照顾者提供关于 SUDEP 的信息可能会提高药物依从性,而不会对生活质量或情绪产生不良影响。需要进行设计良好、方法学质量高的研究,以确定披露 SUDEP 信息对 PWE 药物依从性的具体影响大小。