Among patients with epilepsy, addressing the side effects of anti-seizure medications at every doctor’s visit does not increase patients’ adherence to their medications. That said, researchers emphasize the assessment of side effects remains an important, albeit neglected, aspect of epilepsy care.
Epilepsy is one of the most prevalent life-threatening neurological disorders in the U.S., and is characterized by recurrent spontaneous seizures. Most types of epilepsy are incurable, so continuous anti-epileptic drug (AED) treatment is recommended. However, all the currently available anti-seizure drugs have varying side-effect profiles. People with epilepsy often have other medical conditions, placing them at increased risk of toxicity, drug interactions, and reduced adherence to treatment.
Incomplete adherence to treatment has been associated with several clinical and psychosocial determinants. Less education, the presence of psychiatric disorders, and poor seizure control has been associated with incomplete adherence. Based on this evidence, clinicians must work closely with their patients to balance the benefits of a medication with the potential side effects that may reduce adherence.
In the new study Daniel Hoch, MD, PhD, at Harvard Medical School investigated if addressing the side effects of an antiepileptic drug (AED) at every visit to the doctor was associated with increased patient-reported adherence to medication. Hoch’s researchers identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits to the doctor over a period of three years. Evidence that AED side effects were assessed through patient-reported phone interviews and medical records.
A total of 62 subjects (25%) completed the phone interviews. According to their medical records, AED side effects were addressed in 48 (77%) of them. However, the phone interviews themselves revealed this number to be 51 (82%).
Twenty-eight (45%) of the patients reported complete adherence to their anti-epileptic medication. Patients reported that the most common reason for incomplete medication adherence was due to forgetfulness (31 of the 34 remaining patients, 91%).
The researchers found no association between addressing AED side effects and complete medication adherence (neither documented in medical records nor reported by patients).
“Addressing AED side effects remains a neglected part of epilepsy care and should be incorporated in the development of a model that can predict quality of care,” the researchers stated in a press release.