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(PWE)在采取适当的抗癫痫药(AED)方案后可实现癫痫发作自由,但证据表明PWE对AED的依从性不佳。对AED的不依从会增加发病率,死亡率,急诊就诊和住院治疗,依从性的降低也与生活质量降低,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用药错误在癫痫病中研究较少,但也有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确定药物依从率,并将其与在普通癫痫门诊就诊的PWE队列中感知到的药物错误相关。经过一个计划-研究-学习-行动周期,发现最合适的进行方法是定制的9项自我管理调查表。一百八十六个PWE完成了一个九个问题的问卷调查,询问患者自己的用药习惯以及他们以前曾遭受过用药错误的感觉。这项研究发现,有41%的受访者表示对AED治疗的依从性不佳,而28.5%的受访者自我报告说,他们无意间不定期,定期或频繁地服用AED药物。 5.9%的受访者自我报告说,他们有意不按处方服用药物。 6%的受访者自我报告说,他们无意和有意不遵守AED治疗。没有证据表明年龄,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不依从之间存在显着相关性。问卷调查的28​​.5%的受访者表示,他们认为自己遭受了用药错误。开处方错误是感知到的用药错误的最常见形式,其次是配药错误,然后是给药错误。发现无效的药物与对癫痫病的耻辱感或尴尬感以及明显的处方错误之间存在显着关联。故意不坚持用药与感觉到的配药错误显着相关。

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