UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs

Chapman, SCE; Horne, R; Eade, R; Balestrini, S; Rush, J; Sisodiya, SM; (2015) Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs. Epilepsia , 56 (9) pp. 1398-1407. 10.1111/epi.13097. Green open access

[thumbnail of epilepsy_UK_revised_FINAL resubmission 3.pdf]
Preview
Text
epilepsy_UK_revised_FINAL resubmission 3.pdf
Available under License : See the attached licence file.

Download (561kB) | Preview

Abstract

Summary Objective Nonadherence to antiepileptic drugs (AEDs) is a common cause of poor seizure control. This study examines whether reported adherence to AEDs is related to variables identified in the National Institute for Health and Clinical Excellence (NICE) Medicines Adherence Guidelines as being important to adherence: perceptual factors (AED necessity beliefs and concerns), practical factors (limitations in capability and resources), and perceptions of involvement in treatment decisions. Methods This was a cross-sectional study of people with epilepsy receiving AEDs. Participants completed an online survey hosted by the Epilepsy Society (n = 1,010), or as an audit during inpatient admission (n = 118). Validated questionnaires, adapted for epilepsy, assessed reported adherence to AEDs (Medication Adherence Report Scale [MARS]), perceptions of AEDs (Beliefs about Medicines Questionnaire [BMQ]), and patient perceptions of involvement in treatment decisions (Treatment Empowerment Scale [TES]). Results Low adherence was related to AED beliefs (doubts about necessity: t(577) = 3.90, p < 0.001; and concerns: t(995) = 3.45, p = 0.001), reported limitations in capability and resources (t(589) = 7.78, p < 0.001), and to perceptions of a lack of involvement in treatment decisions (t(623) = 4.48, p < 0.001). In multiple logistic regression analyses, these factors significantly (p < 0.001) increased variance in reported adherence, above that which could be explained by age and clinical variables (seizure frequency, type, epilepsy duration, number of AEDs prescribed). Significance Variables identified in the NICE Medicines Adherence Guidelines as potentially important factors for adherence were found to be related to adherence to AEDs. These factors are potentially modifiable. Interventions to support optimal adherence to AEDs should be tailored to address doubts about AED necessity and concerns about harm, and to overcome practical difficulties, while engaging patients in treatment decisions.

Type: Article
Title: Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/epi.13097
Publisher version: http://dx.doi.org/10.1111/epi.13097
Language: English
Additional information: This is the peer reviewed version of the following article: Chapman, SCE; Horne, R; Eade, R; Balestrini, S; Rush, J; Sisodiya, SM; (2015) Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs. Epilepsia 56 (9) pp. 1398-1407., which has been published in final form at http://dx.doi.org/10.1111/epi.13097. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Epilepsy; Medication adherence; Antiepileptic drugs; Beliefs about medicine; Treatment decisions
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/1471675
Downloads since deposit
574Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item