Educational Program to Improve Drug Adherence in Pediatric Epilepsy Patients and Caregivers in Limited Resource Area

Abstract

Poor drug adherence can lead to poor seizure control in pediatric epilepsy patients. Patients' knowledge about drug compliance is the cornerstone to improving drug adherence. In the past, several educational programs have involved multidisciplinary teams, including many specialists, who were recruited to spread and improve awareness about good drug adherence; however, there are few studies conducted in a limited resource country. This paper aims to outline a new program created by our clinicians. The epilepsy alert system (EAS) is an accessible educational program for pediatric epilepsy patients and caregivers, which is suitable for limited resource areas and evaluates the benefit of EAS on drug adherence. The EAS consists of a 20-minute-long educational program, co-led by a pediatric neurologist, a pediatrician, and a pharmacist, using simple tools such as an epilepsy diary and an epilepsy card. Epileptic children aged 1 month to 15 years who visited a pediatric epilepsy clinic between August 1, 2017 and September 30, 2018 were included. Drug adherence was evaluated using the four-item Morisky's Medication Adherence Scale. Comparison of drug adherence occurred prior to and at a 3- and 6-month follow-up, after participants received the educational program. A total of 108 patients were enrolled. Of these, the participants' mean age was 7 years and 6 months. Males constituted 59.3% of the cohort. The most common seizure type is focal epilepsy and 22.4% of the cohort had intractable epilepsy. 41% of participants had a “poor” adherence at baseline. After recruited to EAS, the poor drug adherence was significantly decreased to 23 and 14% at the 3- and 6-month follow-up, respectively. EAS is a suitable educational program for clinicians to employ when trying to improve drug adherence in pediatric epilepsy patients and caregivers in a limited resource area.

Keywords

pediatric epilepsy - drug adherence - educational program - limited resource area

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