Patients' perspectives on antiepileptic medication: relationships between beliefs about medicines and adherence among patients with epilepsy in UK primary care

Epilepsy Behav. 2014 Feb:31:312-20. doi: 10.1016/j.yebeh.2013.10.016. Epub 2013 Nov 27.

Abstract

Background: Nonadherence to antiepileptic drugs (AEDs) can result in suboptimal outcomes for patients.

Aim: This study aimed to assess the utility of a theory-based approach to understanding patient perspectives on AEDs and adherence.

Method: Patients with epilepsy, identified by a GP case note review, were mailed validated questionnaires assessing their perceptions of AEDs and their adherence to them.

Results: Most (84.9%) of the 398 AED-treated respondents accepted the necessity of AEDs, but over half expressed doubts, with 55% disagreeing or uncertain about the statement 'I would prefer to take epilepsy medication than risk a seizure'. Over a third (36.4%) expressed strong concerns about the potential negative effects of AEDs. We used self-report and medication possession ratio to classify 36.4% of patients as nonadherent. Nonadherence was related to beliefs about medicines and implicit attitudes toward AEDs (p<0.05). Adherence-related attitudes toward AEDs were correlated with general beliefs about pharmaceuticals (BMQ General: General Harm, General Overuse, and General Benefit scales) and perceptions of personal sensitivity to medicines (PSM scale).

Conclusion: We identified salient, adherence-related beliefs about AEDs. Patient-centered interventions to support medicine optimization for people with epilepsy should take account of these beliefs.

Keywords: Antiepileptic drugs; Beliefs about Medicines Questionnaire (BMQ); Epilepsy; Medicine adherence; Perceived Sensitivity to Medicines (PSM) scale; Primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anticonvulsants / therapeutic use*
  • Culture*
  • Epilepsy / drug therapy*
  • Epilepsy / epidemiology
  • Epilepsy / psychology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence / psychology*
  • Middle Aged
  • Perception
  • Primary Health Care*
  • Severity of Illness Index
  • United Kingdom / epidemiology

Substances

  • Anticonvulsants