Compliance with Antiepileptic Medication: a Two-Year Follow-Up Study of Adults with Epilepsy.

Abstract

Compliance with antiepileptic medication was evaluated in an adult seizure population. Data collected at two points in time, two years apart, were analyzed for 87 adults from four clinics in the metropolitan Minneapolis-St. Paul area. Results indicated that individual compliance scores were not correlated with each other for the two points in time when measured by self-report or when measured by an objective serologic test. The serologic test is called the coefficient of variation and is obtained by dividing the st and ard deviation of three sequential blood levels by the mean of the three blood levels. Self-reported compliance was significantly correlated with the coefficient of variation in the follow-up study. Most of the predictor variables studied, including health beliefs and faith in the provider of care, were significantly correlated between the initial and follow-up studies. Significant Pearson product-moment correlations for the CV included: income (.33), total number of seizures (.25), perceived inefficacy of the regimen (-.26) and past experience without medication (-.29). Significant correlations for self-reported compliance included: tendency to disclose seizures to others (.37) and commitment to the regimen (.26). The correlation between perceived difficulty in complying and self-reported compliance bordered on statistical significance (-.20). Alternative path models were proposed and tested in order to better underst and direct and indirect effects of predictor variables on compliance. Recency of seizures, age and income related to complaince through their effects on health beliefs, commitment to the regimen and tendency to disclose seizures. Consideration of the relationship of compliance to treatment outcome, improved specification of the dimensions of commitment and personal responsibility and continued attention to different patterns of compliance are suggested as important for future studies of compliance with antiepileptic medication.