April 15, 2019

Nonadherence to Treatment Regimens Associated with Feeling Depressed and Perceptions of Stigmatization: Differences Between Intentional and Unintentional Lack of Adherence

Nonadherence to recommended antiepileptic drug (AED) treatment regimens can result in seizure relapse with increased health risks. Nonadherence can be unintentional (eg, patients forget to take a dose), or intentional, when patients consciously decide not to follow the agreed AED treatment regimen. This study aims to determine the extent to which Norwegian patients with epilepsy (PWEs) report taking their AED differently from prescribed, either intentionally or unintentionally, and to identify risk factors for either form of nonadherence.

Of 1182 PWEs who completed an online survey presented on the website of the Norwegian Epilepsy Association, 40% reported that they sometimes or often forget to take their AED as scheduled, and about 30% reported that they consciously chose not to follow the AED treatment plan agreed upon with their physician.

Independent variables significantly associated with unintentional nonadherence include the following: feeling depressed, being younger than the mean age, and having memory problems. Independent factors significantly associated with intentional nonadherence include the following: feeling depressed, male gender, and perceptions of stigmatization.

To improve the treatment of patients with epilepsy, it is important to distinguish between intentional and unintentional nonadherence to antiepileptic drug treatment regimens, as different risk factors and reasons associated with nonadherence to AED treatment regimens might require different interventions.

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