Farrukh Muhammad Junaid, Makmor-Bakry Mohd, Hatah Ernieda, Tan Hui Jan
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
Patient Prefer Adherence. 2018 Oct 11;12:2111-2121. doi: 10.2147/PPA.S179031. eCollection 2018.
To identify the use pattern of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy.
Potential studies were identified through a systematic search of Scopus, Science Direct, Google Scholar, and PubMed. The keywords used to identify relevant articles were "adherence," "AED," "epilepsy," "non-adherence," and "complementary and alternative medicine." An article was included in the review if the study met the following criteria: 1) conducted in epilepsy patients, 2) conducted in patients aged 18 years and above, 3) conducted in patients prescribed AEDs, and 4) patients' adherence to AEDs.
A total of 3,330 studies were identified and 30 were included in the final analysis. The review found that the AED non-adherence rate reported in the studies was between 25% and 66%. The percentage of CAM use was found to be between 7.5% and 73.3%. The most common reason for inadequate AED therapy and higher dependence on CAM was the patients' belief that epilepsy had a spiritual or psychological cause, rather than primarily being a disease of the brain. Other factors for AED non-adherence were forgetfulness, specific beliefs about medications, depression, uncontrolled recent seizures, and frequent medication dosage.
The review found a high prevalence of CAM use and non-adherence to AEDs among epilepsy patients. However, a limited number of studies have investigated the association between CAM usage and AED adherence. Future studies may wish to explore the influence of CAM use on AED medication adherence.
确定癫痫患者补充和替代医学（CAM）的使用模式及其对抗癫痫药物（AED）依从性的影响。
通过系统检索Scopus、Science Direct、谷歌学术和PubMed来识别潜在研究。用于识别相关文章的关键词为“依从性”“AED”“癫痫”“不依从性”和“补充和替代医学”。如果研究符合以下标准，则纳入该综述：1）在癫痫患者中进行；2）在18岁及以上患者中进行；3）在开具AED处方的患者中进行；4）患者对AED的依从性。
共识别出3330项研究，最终分析纳入了30项。该综述发现，研究报告的AED不依从率在25%至66%之间。发现CAM的使用率在7.5%至73.3%之间。AED治疗不足和对CAM更高依赖的最常见原因是患者认为癫痫有精神或心理原因，而非主要是脑部疾病。AED不依从的其他因素包括健忘、对药物的特定信念、抑郁、近期癫痫发作未得到控制以及频繁的药物剂量。
该综述发现癫痫患者中CAM的使用率和AED不依从率较高。然而，仅有少数研究调查了CAM使用与AED依从性之间的关联。未来的研究不妨探讨CAM使用对AED药物依从性的影响。
