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Evidence summaries

Strategies for Improving Adherence to Antiepileptic Drug Treatment in Epilepsy

Intensive reminders and 'implementation intention' interventions might possibly be promising in enhancing adherence to antiepileptic medications in epilepsy. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 12 RCTs with a total of 1642 patients with epilepsy. Eight studies targeted adults with epilepsy, one study included participants of all ages, one study included participants older than 2 years, one study targeted caregivers of children with epilepsy, and one study targeted families of children with epilepsy. Follow-up time was generally short in most trials, ranging from one to 12 months. The trials examined 3 main types of interventions: educational interventions, behavioural interventions and mixed interventions. All studies except two compared treatment vs. usual care or 'no intervention'. Education and counselling of participants with epilepsy resulted in mixed success. Behavioural interventions such as use of intensive reminders provided more favourable effects on adherence. The effect on adherence to antiepileptic drugs described by studies of mixed interventions showed improved adherence in the intervention groups compared to the control groups.

Comment: The quality of the evidence is downgraded by study quality (unclear allocation concealment, short follow-up time), inconsistency (heterogeneity in interventions and outcomes) and imprecise results (few patients with wide confidence intervals).

    References

    • Al-Aqeel S, Gershuni O, Al-Sabhan J et al. Strategies for improving adherence to antiepileptic drug treatment in people with epilepsy. Cochrane Database Syst Rev 2017;2():CD008312. [PubMed]

Primary/Secondary Keywords