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Ogunjimi L, Alabi A, Aderinola A, Ogunjimi O, Oladunjoye Y, Kasali A, Kasumu E, Oyenuga I, Akinbodu S, Onipede M, Dele O, Adeyemo S, Osalusi B. Predictors and associated factors with adverse drug reaction in people with epilepsy. Epilepsy Behav 2024; 150:109566. [PMID: 38071827 DOI: 10.1016/j.yebeh.2023.109566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES There is a need for early identification and intervention of Adverse Drug Reaction (ADR) to alleviate the unacceptably growing burden, morbidity, and mortality associated with People With Epilepsy (PWE). This study is aimed at identifying associated factors and predictors of ADR among PWE. METHODS It is an interviewer-administered questionnaire-based study consisting of 940 consenting participants aged 16 years and above attending epilepsy clinics for 5 years with diagnosis confirmed by International League against Epilepsy (ILAE) criteria and supported by Electroencephalography (EEG). Twenty-one-item Liverpool Adverse Effect Profile (LAEP) and 8-item Morinsky Medication Adherence Scale (MMAS) were used to assess ADR and adherence respectively. RESULTS The highest reported ADR in PWE were nervousness (34.3%), aggression (33.6%), and weight gain (32.3%). Specifically, 20.1% of the participants complained of memory problems. On the other hand, ADR associated with skin, mouth/gum and hair loss was 9.3%, 8.9%, and 7.2% respectively, and these were the lowest reported ADRs. Using the MMAS, 545(90.2%), 28(4.6%), and 31(5.1%) of PWE in this study were classified as having high, medium, and low adherence, respectively. Duration of Anti-Seizure Medication (ASM) use and duration of epilepsy were the major determinants of ADR in PWE on the regression model. CONCLUSION Duration of ASM use and duration of epilepsy are the major determinants of ADR in PWE. Effective strategies to identify and reduce ADR should be incorporated into the management of PWE by Health Care Providers (HCPs) to improve their quality of life.
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Affiliation(s)
- Luqman Ogunjimi
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria.
| | - Akinyinka Alabi
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Aderonke Aderinola
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Olabisi Ogunjimi
- Department of Pharmacy, University College Hospital, Ibadan, Oyo state, Nigeria
| | - Yusuf Oladunjoye
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Adeola Kasali
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Emmanuel Kasumu
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Ibironke Oyenuga
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Shittabey Akinbodu
- Department of Physiology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Modupeoluwa Onipede
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Oludolapo Dele
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Stella Adeyemo
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
| | - Bamidele Osalusi
- Department of Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu, Ogun state, Nigeria
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Pablo Orozco-Hernández J, Stiven Marín-Medina D, Valencia-Vásquez A, Felipe Quintero-Moreno J, Carmona-Villada H, Lizcano A. Predictors of adverse effects to antiseizure drugs in adult patients with epilepsy from Colombia: A case-control study. Epilepsy Behav 2023; 146:109383. [PMID: 37549466 DOI: 10.1016/j.yebeh.2023.109383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION Adverse drug reactions (ADRs) to antiseizure therapy can worsen the quality of life, reduce adherence, and potentially lead to treatment discontinuation and uncontrolled seizures. OBJECTIVES The aim of the study was to develop a prognostic model for ADRs to antiseizure therapy in adult patients with epilepsy from Colombia. METHODS This case-control study included adult patients with epilepsy, who were separated into two groups: one group with ADRs to antiseizure therapy (cases), as determined by a complete evaluation conducted by an epileptologist, and another group without ADRs (controls). Variables were analyzed to identify statistical differences between the two groups and were then selected to construct a prognostic model using logistic regression. The Bonferroni method was applied for multiple comparisons. RESULTS Three hundred fifty-four patients with epilepsy were studied. One hundred and fifty (42%) patients had ADRs and 204 (57%) patients did not have ADs. A total of 362 ADRs were reported, with a third of them being general symptoms and most frequently occurring with older-generation antiseizure drugs (58%). Female sex, drug-resistant epilepsy, LEV, and CZP were risk factors, whereras the presence of tumoral etiology, absence of seizure triggers, and VPA were identified as protective factors. A prognostic model was constructed using previously reported risk factors for ADRs to antiseizure therapy and other variables available in this population study. In the multivariable analysis, the number of previously used antiseizure drugs (1, 2, or ≥3), TPM, CZP, LEV, PHT, and female sex were predictors of ADRs. The corrected p-values were estimated by the Bonferroni method; however, not all the variables achieved statistical significance with this adjustment. CONCLUSIONS In adult patients with epilepsy from Colombia, we found that the number of previously used antiseizure drugs, TPM, CZP, LEV, PHT, and female sex were predictive factors for ADRs to antiseizure therapy.
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Affiliation(s)
- Juan Pablo Orozco-Hernández
- Grupo de Investigación NeuroUnal, Division of Neurology, Universidad Nacional de Colombia, Bogotá, Colombia; Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia
| | - Daniel Stiven Marín-Medina
- Grupo de Investigación NeuroUnal, Division of Neurology, Universidad Nacional de Colombia, Bogotá, Colombia; Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia.
| | - Aníbal Valencia-Vásquez
- Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia; Programa de Medicina, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Risaralda, Colombia
| | - Juan Felipe Quintero-Moreno
- Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia; Programa de Medicina, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Risaralda, Colombia
| | - Hans Carmona-Villada
- Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia
| | - Angélica Lizcano
- Grupo de Investigación Applied Neuroscience, Neurocentro S.A., Instituto de Epilepsia y Parkinson del Eje Cafetero, Pereira, Risaralda, Colombia
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Luqman O, Joseph Y, Akintomiwa M, Akinyinka A, Aderonke A, Bamidele O, David O, Mojisola OB, Bolanle F, Abdullahi M, Olatunbosun O, Fehintola F, Adesola O. Determinants of quality of life in Nigerian female patients with epilepsy on carbamazepine and levetiracetam monotherapy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Abstract
Background
The study is aimed to identify the predictors of Quality of Life (QOL) in women with epilepsy (WWE) on carbamazepine (CBM) and levetiracetam (LTM) monotherapy. 100 WWE were recruited (50 each on CBM and LTM), after clinical diagnosis of epilepsy supported by Electroencephalography (EEG) features and seizures classification by 2017 International League Against Epilepsy (ILAE) criteria, the Quality of Life Inventory Scale 31(QOLIE-31) and Zung Self-Rating Depression Scale (ZSRDS) were used to assess QOL and depression, respectively.
Result
Higher QOLIE-31 scores was seen in the LTM group across all domains except seizure worry (p = 0.051) compared to CBM group. Logistic regression showed that the use of CBM (p = 0.000), fast frequency on EEG (p = 0.005), longer duration of epilepsy (p = 0.017), presence of depression (p = 0.008) and lower level of education (p = 0.003) were predictors of QOL. Progesterone (p = 0.040), oestradiol (p = 0.011) and prolactin (p = 0.002) in follicular phase showed significant association with QOLIE-total score. In the luteal phase, luteinizing hormone–follicle stimulating hormone (LH–FSH) ratio (p = 0.009) and testosterone (p = 0.015), FSH (p = 0.015), prolactin (p = 0.000), showed significant association with QOL. None of the hormones independently predicts QOL.
Conclusion
LTM group appears to have better QOL than CBM group. Healthcare providers should focus on addressing these identified predictors which include medication effect, depression, Level of education, EEG background and duration of epilepsy with aim of improving QOL.
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Fu J, Tao T, Li Z, Chen Y, Chen X, Li J, Peng L. Effects of Sodium Valproate Monotherapy on Blood Liver Enzyme Levels in Patients with Epilepsy: A Meta-Analysis. Horm Metab Res 2021; 53:425-434. [PMID: 34282594 DOI: 10.1055/a-1517-6550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We conducted this meta-analysis to assess the effects of sodium valproate (VPA) monotherapy on blood liver enzymes in patients with epilepsy. PubMed, Web of Science, EBSCO, Cochrane Library, Wanfang, China national knowledge infrastructure databases were searched. Nine studies were included. Results showed: (1) The overall SMD for blood AST, ALT, and GGT levels of VPA monotherapy group versus control group were 0.70 (95% CI=0.31 to 1.09, Z=3.52, p=0.0004), 0.47 (95% CI=- 0.01 to 0.95, Z=1.91, p=0.06), 0.44 (95% CI=0.29 to 0.60, Z=5.55, p<0.00001), respectively. (2) In subgroup meta-analysis, increased blood AST and GGT levels were observed in epileptic minors (AST: total SMD=0.85, 95% CI=0.40 to 1.30, Z=3.69, p=0.0002; GGT: total SMD=0.46, 95% CI=0.29 to 0.63, Z=5.25, p<0.00001). Elevated blood ALT level was observed in Asian patients receiving VPA monotherapy (total SMD=0.70, 95% CI=0.51 to 0.90, Z=7.01, p<0.00001), and the early stage of VPA monotherapy (total SMD=0.93, 95% CI=0.57 to 1.29, Z=5.09, p<0.00001). Overall, our results indicated that blood AST and GGT were significantly increased in epileptic minors receiving VPA monotherapy. The elevation of blood ALT was observed in Asian patients and the early stage of VPA monotherapy. However, due to the small number of included studies, our results should be considered with caution.
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Affiliation(s)
- Jie Fu
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Tao
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zuoxiao Li
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yangmei Chen
- Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiu Chen
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jinglun Li
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lilei Peng
- Department of Neurosurgery, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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Akosile CO, Anomneze JU, Okoye EC, Adegoke BOA, Uwakwe R, Okeke E. Quality of life, fatigue and seizure severity in people living with epilepsy in a selected Nigerian population. Seizure 2020; 84:1-5. [PMID: 33248424 DOI: 10.1016/j.seizure.2020.10.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Epilepsy, a chronic seizure disorder, can cause elevated fatigue and reduced quality of life (QOL) of the sufferers. Hence, improving QOL, seizure severity (SS) and fatigue are important areas of therapeutic interventions for people living with epilepsy (PLWE). Therefore, there is need to ascertain the levels and interrelationships among these constructs in PLWE. OBJECTIVE This study compared fatigue and QOL of PLWE with those of apparently healthy individuals (AHIs) and also determined the interrelationships between fatigue, QOL and SS in PLWE. METHOD This cross-sectional survey involved 91 PLWE and 101 AHIs consecutively recruited from purposively selected hospitals and hosting communities. The Short-form Health Survey (SF-36) questionnaire, the Fatigue Severity Scale, the Modified Fatigue Impact Scale and the Seizure Severity Questionnaire were used to evaluate QOL, fatigue severity (FS), fatigue impact (FI) and SS respectively. Data was analyzed using frequency count, proportions, mean and standard deviation, range, Chi-square test, Mann-Whitney U test and Spearman-rank order correlation. Alpha level was set at 0.05. RESULTS PLWE had significantly lower QOL compared to AHIs (U = 3057.00;p < 0.01). The two groups however experienced similar fatigue severity, but PWE suffered greater fatigue impact (U = 2798.00;p < 0.01). Significant relationships existed among FI, FS, SS and QOL in PLWE (p < 0.01). CONCLUSION Compared with AHIs, PLWE had poorer QOL, similar FS, and higher FI. QOL of PLWE was negatively associated with SS, FI and FS. Clinical interventions geared towards minimizing seizure, severity and impact of fatigue may improve the QOL of PLWE.
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Affiliation(s)
- Christopher Olusanjo Akosile
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.
| | - John Uche Anomneze
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.
| | - Emmanuel Chiebuka Okoye
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.
| | | | - Richard Uwakwe
- Department of Psychiatry, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.
| | - Emeka Okeke
- Rise Clinic Nigeria and Global Health Initiative Adazi-ani, Anambra State, Nigeria.
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Sunny AA, Iyer RS, Kumaran SG, Bunshaw NG, Shanmugham K, Govindaraj U. Affordability, availability and tolerability of anti-seizure medications are better predictors of adherence than beliefs: Changing paradigms from a low resource setting. Seizure 2020; 83:208-215. [PMID: 33227659 DOI: 10.1016/j.seizure.2020.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/11/2020] [Accepted: 11/07/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Anti-seizure medication (ASM) non-adherence contributes to treatment gap and increases mortality and morbidity associated with epilepsy. Beliefs about medications are considered better predictors of ASM non-adherence than clinico-demographic factors. We aimed to look into ASM non-adherence rates among adults with epilepsy (AWE), identify the contributing barriers and determine whether medication beliefs were more powerful predictors than clinico-demographic factors. METHODS This was a cross-sectional study of AWE receiving ASMs. Participants (n = 304) were assessed by validated questionnaires, for non-adherence (8-item Morisky Medication Adherence Scale) and perceptions of ASMs (Beliefs about Medicines Questionnaire) along with clinico-demographic details. RESULTS Our group with high literacy and low-income had a high non-adherence rate (55 %) despite having positive beliefs (Mean necessity-concern differential [NCD] = 2.86). Among the beliefs, ASM non-adherence was significantly associated with ASM-concern (t = 4.23, p < 0.001) and NCD (t = -4.11, p < 0.001). Stepwise multiple linear regression analysis showed that non-adherence was significantly associated with per-capita income (β -0.215, p < 0.001), ASM side effects (β 0.177, p = 0.001), high seizure frequency (β 0.167, p = 0.002), ASM availability (β -0.151, p = 0.004), ASM costs (β -0.134, p = 0.013 and NCD (β -0.184, p = 0.001). NCD accounted for 2.9 % of the variance in non-adherence whereas the other clinico-demographic variables together accounted for 14.6 %. CONCLUSION We describe a paradigm shift in AWE with high non-adherence to ASMs, wherein clinico-demographic variables emerge as better predictors of non-adherence than beliefs. High literacy facilitates the perception of need for ASMs whereas costs and side effects hamper adherence.
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Affiliation(s)
- Anita Ann Sunny
- Department of Neurology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Rajesh Shankar Iyer
- Department of Neurology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
| | - Soumya Gopalan Kumaran
- Department of Neurology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Nadiya Grace Bunshaw
- Department of Neurology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Karthikeyan Shanmugham
- Department of Community Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Uma Govindaraj
- Department of Statistics, PSG College of Arts & Science, Coimbatore, Tamil Nadu, India
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Abd Wahab ES, Al Omar M, Altabakha MMAM. Adherence to Antiepileptic Drugs among Patients Attending the Neuro Spinal Hospital in the United Arab Emirates. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:499-507. [PMID: 33679099 PMCID: PMC7909063 DOI: 10.4103/jpbs.jpbs_367_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/20/2020] [Accepted: 05/29/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Adherence to antiepileptic drugs (AEDs) is an integral component of epilepsy management. There are no previous data in the United Arab Emirates (UAE). Objectives: The aim of this study was to assess the prevalence of AED adherence among patients attending the Neuro Spinal Hospital in UAE and to identify the predictors of nonadherence. Materials and Methods: A cross-sectional study was conducted between April 2018 and May 2019, and included consecutive patients with epileptic who were receiving AEDs for at least 6 months. A validated interviewer-administered questionnaire was used. Adherence was assessed by four-item Morisky’s Medication Adherence Scale with a score between 0 and 4. Patients were considered adherent or nonadherent for a score of zero, or 1 and more, respectively. Chi-square test, binary, and multiple logistic regression analysis were used. Results: The study included 315 respondents, 70.8% (n = 223) were adherent, the rest were nonadherent. The most common factor affecting adherence was forgetfulness. Lower education level and having a seizure within the last 6 months were significant risk of nonadherence (odds ratio [OR] 95% confidence interval [CI] = 2.6 (1.2–5.8) and 2.5 (1.3–5.2), respectively), whereas levetiracetam intake reduces the risk of nonadherence (OR: 0.5 [0.2–0.9]). Conclusions: The prevalence of AED adherence was 70.8%. Education level and having a seizure in the last 6 months were significant predictors of nonadherence, whereas levetiracetam intake reduces the risk of nonadherence.
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Affiliation(s)
- Enas S Abd Wahab
- Department of Pharmacy, Neuro Spinal Hospital, Dubai, United Arab Emirates
| | - Muaed Al Omar
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Moawia M A M Altabakha
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Siqueira HH, Dalbem JS, Schiavini M, Silva PE, Costa TBP, Leite PHSC, Koeche B, Diesel M, Scolari LP, Wolf P, Walz R, Lin K. Self-reported adherence among people with epilepsy in Brazil. Epilepsy Behav 2020; 103:106498. [PMID: 31653605 DOI: 10.1016/j.yebeh.2019.106498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonadherence rates among people with epilepsy (PWE) are widely variable, ranging from 26% to 95.4%. We aimed to identify nonadherence in Brazil, its determinant factors, its impact on patients' management, and to compare it with other chronic nonparoxysmal diseases. METHODS A multicenter observational case-control study was conducted between March 2015 and October 2016, and 153 subjects were included. Subjects' clinical-epidemiological data were surveyed with the Morisky-Green test (MGT), Brief Medication Questionnaire (BMQ), and the Liverpool adverse events profile (LAEP). RESULTS One hundred three PWE and 50 controls with other, nonparoxysmal chronic conditions were interviewed; both groups were matched according to age and socioeducational level. People with epilepsy were aged 36.4 ± 13.9 (range 18-67), 55% were women, mean age at epilepsy onset was 18.1 ± 15.5 years, 51.5% had pharmacoresistant epilepsy, and 48.5% were on monotherapy. 74.8% of patients and 70.0% controls were nonadherent to treatment according to MGT (p = 0.58); and barrier of recall (BMQ) was associated with nonadherence in 78% of PWE and 76% of controls (p = 0.84). Binary logistic regression analysis revealed LAEP (OR 1.05; 95%CI = 1.01-1.09; p = 0.03) and self-reported frequency of forgetfulness on the last three months (OR 19.13; 95%CI = 2.40-152.28; p < 0.01) as the main factors associated with nonadherence. Nonadherent subjects did not have more seizures and did not need emergency treatment more often than adherent ones. CONCLUSION Three of four PWE were not fully adherent to their treatment. Adherence assessment should be routine in all outpatient visits as well as interventions aimed to improving it. Adverse events are important predictors of adherence, and they should be considered when choosing the initial treatment of epilepsy.
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Affiliation(s)
- Heloise Helena Siqueira
- Medical Sciences Graduation Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Neurology Division, Hospital Geral Universitário, Cuiabá, MT, Brazil.
| | - Juliane Salter Dalbem
- Medical Sciences Graduation Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil
| | - Marcel Schiavini
- Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil
| | - Paulo Eduardo Silva
- Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil
| | | | | | - Bruna Koeche
- Neurology Division, Hospital Geral Universitário, Cuiabá, MT, Brazil
| | - Marcelo Diesel
- Neurology Division, Hospital Geral Universitário, Cuiabá, MT, Brazil
| | | | - Peter Wolf
- Medical Sciences Graduation Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Danish Epilepsy Centre, Dianalund, Denmark
| | - Roger Walz
- Medical Sciences Graduation Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Center for Applied Neurosciences (CeNAp), Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil
| | - Katia Lin
- Medical Sciences Graduation Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Center for Applied Neurosciences (CeNAp), Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil
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Wang J, Huang P, Song Z. Comparison of the relapse rates in seizure-free patients in whom antiepileptic therapy was discontinued and those in whom the therapy was continued: A meta-analysis. Epilepsy Behav 2019; 101:106577. [PMID: 31706169 DOI: 10.1016/j.yebeh.2019.106577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
About 70% of patients with epilepsy can be seizure-free with an appropriate treatment. When the seizures are under control, discontinuation of the antiepileptic drugs (AEDs) can help avoid their side effects; however, it may increase the risk of relapse. Some studies have compared the relapse rates between patients in whom AEDs have been continued and those in whom AEDs have been discontinued. However, it is not clear whether AED discontinuation causes a higher seizure recurrence rate. This meta-analysis aimed mainly to determine whether the seizure recurrence rate was different between seizure-free patients in whom AEDs were continued and those in whom AEDs were discontinued. The I2 value was used for assessing the heterogeneity; the Mantel-Haenszel test was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs). Seven cohort studies and randomized controlled trials (RCTs) met the inclusion criteria. The study quality evaluation was performed respectively using the Newcastle-Ottawa Scale and the Jadad scale. A total of 1253 patients were included. The relapse rate was higher in patients in whom AEDs were discontinued than in those in whom the AED treatment was continued. Furthermore, we also compared the epilepsy recurrence rates after AED discontinuation between seizure-free patients who were on monotherapy with different AEDs (carbamazepine, phenytoin, sodium valproate, and phenobarbitone/primidone). Four studies and 625 patients were included in this analysis. The epilepsy recurrence rates did not significantly differ between the patients on different AED treatment.
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Affiliation(s)
- Jingjing Wang
- Department of Neurology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Pin Huang
- Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhi Song
- Department of Neurology, Third Xiangya Hospital of Central South University, Changsha, China.
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Dormer L. Introducing volume 8 of Neurodegenerative Disease Management. Neurodegener Dis Manag 2019; 8:1-4. [PMID: 29400629 DOI: 10.2217/nmt-2017-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Welcome to the eighth volume of Neurodegenerative Disease Management. At the start of a new volume, it is interesting to look back at which content proved most popular in 2017, and also to take a look forward to the content of this issue and beyond.
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Affiliation(s)
- Laura Dormer
- Future Medicine Ltd, Unitec House, London N3 1QB, UK
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Abstract
This study firstly investigated the feasibility effect and safety of Ganoderma Lucidum Spore Powder (GLSP) for treating patients with epilepsy.Eighteen eligible patients with epilepsy were included. They all received GLSP treatment for a total of 8 weeks. The primary outcome included weekly seizure frequency. The secondary outcomes consisted of each seizure episode, and quality of life, measured by the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), as well as the adverse events (AEs).After treatment, GLSP can significant reduce the weekly seizure frequency, compared with it before the treatment (P = .04). However, GLSP did not exert promising effect in each seizure episode (P = .13), and quality of life, measured by the QOLIE-31 scale (P = .11). Additionally, only minor AEs occurred during the treatment period.The results of this study showed that GLSP may be effective for reducing the weekly seizure frequency. Further studies are still needed to warrant this result.
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Affiliation(s)
- Guo-hui Wang
- First Ward of Neurology Department, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Xin Li
- First Ward of Neurology Department, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Wen-hui Cao
- Second Ward of Neurology Department, Hongqi Affiliated Hospital of Mudanjiang Medical University, Mudanjiang
| | - Jing Li
- Department of Physiology, Basic Medical College, Jiamusi University, Jiamusi, China
| | - Li-hua Wang
- First Ward of Neurology Department, First Affiliated Hospital of Jiamusi University, Jiamusi
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