Although 70% of people with epilepsy (PWE) achieve seizure freedom following an appropriate antiepileptic drug (AED) regime, evidence suggests that adherence to AEDs by PWE is suboptimal. Nonadherence to AEDs is associated with increased morbidity, mortality, emergency department visits, and hospitalizations, with reduced adherence also correlating to a lower quality of life, decreased productivity, and loss of employment. Furthermore, research indicates that medication errors which are widespread in chronic disease are less well studied in epilepsy but are likely also to contribute to avoidable disease morbidity and mortality. The goals of this project were to determine rates of medication adherence by self-reported questionnaire and its links to perceived medication error in a cohort of PWE attending a general epilepsy outpatient clinic. Following a plan-do-study-act cycle, it was found that the most appropriate methodology for conducting was in the form of a bespoke 9-item self-administered questionnaire. One hundred eighty-six PWE completed a nine-question questionnaire asking patients about their own medication adherence habits and their perception that they were previously exposed to medication error. This study found that 41% of respondents reported suboptimal adherence to AED therapy, while 28.5% of respondents self-reported that they unintentionally do not take their AED medication on an occasional, regular, or frequent basis. A 5.9% of respondents self-reported that they intentionally do not take their medication as prescribed. A 6% of respondents self-reported that they are both unintentionally and intentionally nonadherent to their AED therapy. No significant associations were demonstrated between age, sex, perceived effectiveness of medication, feelings of stigma/embarrassment, adverse effects or additional neurological comorbidities, and unintentional or intentional nonadherence. A 28.5% of respondents to the questionnaire reported that they perceived themselves to have been subjected to medication error. Prescribing errors were the most common form of perceived medication error, followed by dispensing errors, then administration errors. Significant associations were found between ineffective medication and feelings of stigma or embarrassment about epilepsy with perceived prescribing errors. Intentional nonadherence to medication was significantly associated with perceived dispensing errors.

译文

尽管有70% 的癫痫患者在适当的抗癫痫药物 (AED) 治疗后获得了癫痫发作的自由,但有证据表明,对PWE对AED的依从性是次优的。不遵守aed与发病率,死亡率,急诊就诊和住院有关,依从性降低还与生活质量降低,生产力下降和失业有关。此外,研究表明,在慢性病中普遍存在的药物错误在癫痫中的研究较少,但也可能导致可避免的疾病发病率和死亡率。该项目的目标是通过自我报告的问卷来确定药物依从性的比率,并确定其与参加普通癫痫门诊的PWE队列中感知到的药物错误的联系。在计划-做-研究-行动周期之后,发现最合适的方法是定制的9项自我管理问卷的形式。一百八十六个pww完成了一个九个问题的问卷调查,询问患者自己的药物依从性习惯以及他们以前曾暴露于药物错误的感觉。这项研究发现,41% 的受访者报告对AED治疗的依从性不佳,而28.5% 的受访者自我报告说,他们无意地不定期,定期或频繁地服用AED药物。5.9% 受访者自我报告说,他们故意不按规定服用药物。6% 受访者自我报告说,他们无意地和有意地不遵守AED疗法。年龄,性别,药物治疗的有效性,耻辱感/尴尬感,不良反应或其他神经系统合并症以及无意或有意的不依从性之间没有显着关联。问卷调查的28.5% 受访者报告说,他们认为自己遭受了用药错误。处方错误是感知到的药物错误的最常见形式,其次是配药错误,然后是给药错误。发现无效药物与对癫痫的污名或尴尬感与处方错误之间存在显着关联。故意不坚持用药与感知到的配药错误显着相关。

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