Mattson R H, Cramer J A, Collins J F
Epilepsy Center, Veterans Administration Medical Center, West Haven, CT 06516.
Epilepsy Res Suppl. 1988;1:111-7.
Treatment of epilepsy depends on adherence to a drug regimen as prescribed and periodic assessment of progress. Typical problems of compliance to medication and adherence to follow-up in long-term epilepsy treatment in a clinical trial were analyzed. Zero drug levels, subtherapeutic levels, variable levels and delayed dose were measures of non-compliance to the drug regimen. Missed visits and non-drug-related dropouts from the study marked non-adherence. Data from 622 patients participating in a multicenter evaluation of the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin and primidone, showed generally good compliance. Only 5% of patients had zero drug levels or greater than or equal to 24 h since prior dose at 2 or more visits. Good adherence to the protocol was demonstrated by 93% attendance as scheduled. The support structure of the study and the availability of a study assistant helped many patients to prevent potential problems and convert patients into excellent adherers.
癫痫的治疗取决于是否坚持按规定的药物治疗方案以及定期评估进展情况。分析了临床试验中长期癫痫治疗中药物治疗依从性和随访依从性的典型问题。零药物水平、亚治疗水平、波动水平和延迟给药是药物治疗方案不依从的指标。错过就诊和与药物无关的退出研究标志着不依从。来自622名参与卡马西平、苯巴比妥、苯妥英和扑米酮疗效及毒性多中心评估患者的数据显示，总体依从性良好。只有5%的患者在两次或更多次就诊时药物水平为零或距上次给药已超过或等于24小时。93%的患者按计划就诊，表明对方案的依从性良好。研究的支持结构和研究助理的配备帮助许多患者预防了潜在问题，并使患者转变为优秀的依从者。
