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Patient Prefer Adherence. 2016 Oct 31;10:2197-2207. eCollection 2016.

Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy.

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Department of Neurology.
Mongan Institute for Health Policy, Department of Medicine, Massachusetts General Hospital; Department of Health Care Policy, Harvard Medical School, Boston, MA.
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.



Adherence to treatment is a critical component of epilepsy management. This study examines whether addressing antiepileptic drug (AED) side effects at every visit is associated with increased patient-reported medication adherence.


This study identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits over a 3-year period. Demographic and clinical characteristics were abstracted. Evidence that AED side effects were addressed was measured through 1) phone interview (patient-reported) and 2) medical records abstraction (physician-documented). Medication adherence was assessed using the validated Morisky Medication Adherence Scale-4. Complete adherence was determined as answering "no" to all questions.


Sixty-two (25%) patients completed the interviews. Participants and nonparticipants were comparable with respect to demographic and clinical characteristics; however, a smaller proportion of participants had a history of drug-resistant epilepsy than nonparticipants (17.7% vs 30.9%, P=0.04). Among the participants, evidence that AED side effects were addressed was present in 48 (77%) medical records and reported by 51 (82%) patients. Twenty-eight (45%) patients reported complete medication adherence. The most common reason for incomplete adherence was missed medication due to forgetfulness (n=31, 91%). There was no association between addressing AED side effects (neither physician-documented nor patient-reported) and complete medication adherence (P=0.22 and 0.20).


Among patients with epilepsy, addressing medication side effects at every visit does not appear to increase patient-reported medication adherence.


antiepileptic drug side effects; epilepsy; medication adherence

Conflict of interest statement

Lidia MVR Moura was the recipient of a 2015 Clinical Research Fellowship sponsored by the American Brain Foundation. John Hsu receives grant funding from NIH (1R01 CA16 4023-04, 2P01AG032952-06A1, R01 HD075121-04, and R01 MH104560-02). Barbara G Vickrey receives funding from NINDS, California Community Foundation, and UniHealth Foundation. The other authors report no conflicts of interest in this work.

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