Abstracts

Rationale: Antiepileptic drugs (AED) are the mainstay of treatment for patients with epilepsy.  Adherence to the prescribed AED regimen is a major factor in achieving a reduced seizure burden, which can decrease morbidity and mortality.  Patients with epilepsy oftentimes complain about difficulty with memory.  Because little is known about the relationship between memory and adherence, the purpose of this project was to determine the impact of memory on AED adherence in patients with epilepsy. Methods: One hundred adult epilepsy patients were recruited for this cross-sectional study from the Ohio State Medical Center’s outpatient Neurology clinic.  Patients who met the inclusion criteria completed measures of subjective (subset of 6 questions from the QOLIE-89) and objective memory (Hopkins Verbal Learning Test-Revised (HVLT-R)), subjective adherence, and mood (Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)).  Refill records from each patient’s local pharmacy were used to objectively assess AED adherence.  Medication Possession Ratios (MPRs) were calculated based on the AED refill records over the previous 6 months.  Patients were considered adherent if their MPR was ≥ 80%. Results: Women made up the majority of the sample (n=59) and on average, patients had been living with epilepsy for nearly 20 years.  From a drug perspective, approximately 40% of the sample were on AED monotherapy, most patients (>70%) took their AEDs twice daily and the mean number of total medications was 4.25 ± 2.98.  Nearly 40% of the patients experienced a seizure in the last month and roughly about the same proportion were seizure-free for the last year.  Based on MPR, 35% of the patients were non-adherent.  Neither subjective (QOLIE-89 subset) nor objective (HVLT-R) memory was different between the adherent and non-adherent patients.  Patients in the Adherent group had significantly lower NDDI-E scores (indicating better mood) than those in the Non-Adherent group (p=0.04). Conclusions: Our initial hypothesis, patients with memory complaints will have lower adherence rates, was incorrect.  However, our secondary objective regarding mood and adherence suggest a correlation. By characterizing adherence in those patients with depressed mood, we may identify patients at greatest risk for non-adherence and subsequent harm.  This information will aid us in our approach to treating future patients and guide further projects.