(2003; 211 pages)
Poor adherence to drug therapy is one of the primary causes of treatment failure.
Forgetfulness of patients that may or may not be linked to memory difficulties, refusal to take medication and side-effects are the factors most commonly associated with decreased adherence. The impact of epilepsy and the side-effects of its treatment on cognition and of limited or compromised cognition on adherence deserve more attention.
The use of memory aids, linking doses to events in the patient's daily schedule or watch alarms, calendar packs, pill cases or specialized dose dispensers may be helpful tools to increase adherence to treatment in patients who regularly forget to take their AEDs. However, no studies demonstrating this were found in the literature search.
Communication with the patient about medication regimens and the value of treatment is extremely important. It can facilitate the identification of problems and barriers to adequate adherence, and help with treatment planning. Also a real partnership between the physician and the patient is needed to set and achieve goals related to treatment outcomes and adherence.
More research on adherence to anti-epileptic therapies is required to:
- deepen our understanding of the epidemiology of adherence;
- provide clear and consistent definitions of adherence;
- evaluate interventions to improve adherence; and
- collect data on adherence in developing countries.