Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo Hokkaido 060-8638, Japan.
Department of Neuropsychiatry, Aichi Medical University, 1-1, Karimata, Yazako, Nagakute-shi, Aichi 480-1195, Japan.
Epilepsy Behav. 2023 Aug;145:109345. doi: 10.1016/j.yebeh.2023.109345. Epub 2023 Jul 11.
Patients with epilepsy (PWE), especially those with Idiopathic Epilepsy (GE), are at a high risk of disadvantage caused by non-adherence. It has been suggested that medical visit behavior may be a surrogate indicator of medication adherence. We hypothesized that patients with IGE would adhere poorly to visits.
This was a retrospective study of PWE who visited the Department of Psychiatry and Neurology at Hokkaido University Hospital between January 2017 and December 2019. Demographic and clinical information on PWE were extracted from medical records and visit data from the medical information system. Non-attendance of outpatient appointments was defined as "not showing up for the day of an appointment without prior notice." Mixed-effects logistic regression analysis was conducted with non-attendance as the objective variable.
Of the 9151 total appointments, 413 were non-attendances, with an overall non-attendance rate of 4.5%. IGE was a more frequent non-attendance than Focal Epilepsy (FE) (odds ratio (OR) 1.94; 95% confidence interval (CI) 1.17-3.21; p = 0.010). History of public assistance receipt was associated with higher non-attendance (OR 2.04; 95% CI 1.22-3.43; p = 0.007), while higher education (OR 0.64; 95% CI 0.43-0.93; p = 0.021) and farther distance to a hospital (OR 0.33; 95% CI 0.13-0.88; p = 0.022), and higher frequency of visits (OR 0.18; 95% CI 0.04-0.86; p = 0.031) were associated with fewer non-attendances. In a subgroup analysis of patients with GE, women were associated with fewer non-attendance (OR 0.31; 95% CI 0.14-0.72; p = 0.006).
GE was more frequent in the non-attendance group than in the FE group. Among patients with GE, females were found to have non-attendance less frequently; however, there was no clear difference in the odds of non-attendance between Juvenile Myoclonic Epilepsy (JME) and IGE other than JME.
癫痫患者（PWE），尤其是特发性癫痫（GE）患者，由于不遵医嘱而处于不利地位的风险较高。有人认为就诊行为可能是药物依从性的替代指标。我们假设 GE 患者就诊依从性较差。
这是一项回顾性研究，纳入了 2017 年 1 月至 2019 年 12 月期间在北海道大学医院精神科和神经内科就诊的 PWE。从病历和医疗信息系统中的就诊数据中提取 PWE 的人口统计学和临床信息。门诊预约失约定义为“无事先通知而未在预约日就诊”。采用混合效应逻辑回归分析，以失约为因变量。
在 9151 次预约中，有 413 次失约，总失约率为 4.5%。GE 比局灶性癫痫（FE）更常失约（优势比（OR）1.94；95%置信区间（CI）1.17-3.21；p=0.010）。领取公共援助的病史与较高的失约率相关（OR 2.04；95%CI 1.22-3.43；p=0.007），而较高的教育程度（OR 0.64；95%CI 0.43-0.93；p=0.021）和与医院的距离较远（OR 0.33；95%CI 0.13-0.88；p=0.022），以及就诊频率较高（OR 0.18；95%CI 0.04-0.86；p=0.031）与较低的失约率相关。在 GE 患者的亚组分析中，女性失约率较低（OR 0.31；95%CI 0.14-0.72；p=0.006）。
GE 组失约率高于 FE 组。在 GE 患者中，女性失约率较低；然而，除 JME 外，JME 和其他 GE 之间的失约风险无明显差异。
