Abstracts

Rationale: Adherence to antiepileptic drug (AED) therapy can play an important role in the effectiveness of pharmacologic treatment of epilepsy. The purpose of the current study was to use an objective measure of adherence, MEMS TrackCaps to: 1) document patterns of adherence for the first month of therapy for children with new-onset epilepsy; 2) examine differences in adherence by demographic and epilepsy variables; and 3) determine whether treatment adherence improves for a short time preceding a clinic visit (e.g., “white coat compliance”) in this pediatric population. Methods: Participants included 35 children with new-onset epilepsy (Mean age = 7.2 years, 34% female, 66% Caucasian) and their caregivers. Sixty-six percent of children were diagnosed with partial epilepsy and 34% with generalized epilepsy. Adherence to treatment was electronically monitored with MEMS TrackCap, starting with the first AED dose. Adherence was calculated across a one-month period and for the 1-, 3-, and 5 days prior to and 3 days after the clinic appointment.Results: Mean adherence for the first month of treatment in children with new-onset epilepsy was 78.4% (S.D. = 28.2%). One-month adherence was higher in children of married parents (t (33) = -2.1; p < .05) and those with higher socio-economic status (r = 0.44; p < .01), but did not correlate with gender, age, epilepsy type or prescribed medication. Adherence across the entire one-month period was not different than adherence for the 1-, 3-, or 5 days prior to, or 3 days after the clinic visit. Conclusions: Poor adherence seen for children with new-onset epilepsy during the first month of AED therapy is concerning. Several demographic variables influence adherence to treatment, while the proximity to a clinic visit does not. Further studies are needed to: 1) document whether this trend continues longitudinally, 2) identify predictors of non-adherence and 3) determine the clinical impact of poor adherence in order to develop and implement effective adherence interventions. Funded by the Center for the Promotion of Adherence and Self-Management, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center