Abstracts

Rationale: To date, no landmark studies have been published regarding patient adherence to epilepsy medication, yet non-adherence to anti-epileptic drugs (AED) can result in loss of seizure control, impaired quality of life, and productivity. The purpose of this study is to assess the impact of non-adherence on seizure control, quality of life, and productivity in adults with epilepsy.Methods: A cross-sectional survey was conducted among adults with epilepsy. Respondents with epilepsy were recruited from the Harris Interactive chronic illness panel and further qualified with a diagnosis of epilepsy, currently taking an AED, and aged 18 - 64 years. Data were collected on seizure control, rates of adherence, and reasons for non-adherence. Comparisons were made between adherent and non-adherent patients for many factors including impact on quality of life, physical activities, emotional problems, cognition, and lost work/school time. Non-adherent patients were defined as those who self-reported as missing or stopping an AED in the last week or month. Data were weighted to represent the general U.S. population of people with epilepsy. All statistical testing was performed with alpha<0.05.Results: Data were analyzed from 408 adults with epilepsy, with 51% male, mean age of 43, and 81% white. Respondents reported a mean of 1.57 AEDs. Of the 408 respondents, 110 were self-reported non-adherent. When compared to adherent respondents, non-adherent respondents are significantly more likely to report their symptoms as poorly (17%) or not at all controlled (5%) (p<0.05). Non-adherent respondents are also more likely to have 1 or more seizures in the past year (63%) and more convulsive seizures (39%) when compared to adherent respondents (36%, 18% respectively) (p<0.05). Non-adherent respondents more frequently reported having missed a dose of their medication before a seizure occurred (51%) versus adherent respondents (36%) (p<0.05). Non-adherent respondents also experienced greater consequences as a result of a seizure, such as losing or being fired from a job (29%) or depression (25%) as compared to adherent respondents (12%, 10% respectively) (p<0.05). Non-adherent patients were more likely to have been hospitalized (60%) than adherent patients and more likely to have been to the emergency room (75%) when compared with adherent respondents (49%, 66% respectively) (n.s.). Non-adherent respondents (58%) reported that they would be more likely to take their medication as prescribed if they were on a once-a-day treatment.Conclusions: These findings indicate that non-adherent respondents may be less controlled in their epilepsy and experience more consequences associated with seizures (e.g., job loss, driving restrictions, depression). For those who are non-adherent, a once-a-day medication option may aid in improving adherence. Improving adherence may lead to better seizure control, quality of life, and productivity in patients with epilepsy. Sources of funding: GlaxoSmithKline