open access

Vol 53, No 2 (2019)
Research paper
Published online: 2019-02-26
Submitted: 2018-11-19
Accepted: 2018-11-19
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Health-related quality of life and medication adherence in elderly patients with epilepsy

Soudabeh Hamedi-Shahraki, Mohammad-Reza Eshraghian, Mir-Saeed Yekaninejad, Mehdi Nikoobakht, Aliakbar Rasekhi, Hui Chen, Amir Pakpour
DOI: 10.5603/PJNNS.a2019.0008
·
Pubmed: 30807640
·
Neurol Neurochir Pol 2019;53(2):123-130.

open access

Vol 53, No 2 (2019)
Research paper
Published online: 2019-02-26
Submitted: 2018-11-19
Accepted: 2018-11-19

Abstract

Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics.

Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up.

Results. Medication adherence was significantly correlated with both seizure severity (β = –0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = –3.47, p < 0.001) with QoL were supported by the Sobel test.

Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

Abstract

Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics.

Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up.

Results. Medication adherence was significantly correlated with both seizure severity (β = –0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = –3.47, p < 0.001) with QoL were supported by the Sobel test.

Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

Get Citation

Keywords

epilepsy, medication adherence, seizure, quality of life, elderly

About this article
Title

Health-related quality of life and medication adherence in elderly patients with epilepsy

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 2 (2019)

Pages

123-130

Published online

2019-02-26

DOI

10.5603/PJNNS.a2019.0008

Pubmed

30807640

Bibliographic record

Neurol Neurochir Pol 2019;53(2):123-130.

Keywords

epilepsy
medication adherence
seizure
quality of life
elderly

Authors

Soudabeh Hamedi-Shahraki
Mohammad-Reza Eshraghian
Mir-Saeed Yekaninejad
Mehdi Nikoobakht
Aliakbar Rasekhi
Hui Chen
Amir Pakpour

References (48)
  1. Ngugi AK, Bottomley C, Kleinschmidt I, et al. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia. 2010; 51(5): 883–890.
  2. Jacoby A. Stigma, epilepsy, and quality of life. Epilepsy & Behavior. 2002; 3(6): 10–20.
  3. Epilepsy. http://www.who.int/mediacentre/factsheets/fs999/en/ (Accessed Nov 17, 2017).
  4. Mohammadi M, Ghanizadeh A, Davidian H, et al. Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure. 2006; 15(7): 476–482.
  5. Ebrahimi H, Shafa M, Hakimzadeh Asl S. Prevalence of active epilepsy in Kerman, Iran: a house based survey. Acta Neurol Taiwan. 2012; 21(3): 115–124.
  6. Helmers SL, Thurman DJ, Durgin TL, et al. Descriptive epidemiology of epilepsy in the U.S. population: A different approach. Epilepsia. 2015; 56(6): 942–948.
  7. Brodie MJ, Elder AT, Kwan P. Epilepsy in later life. Lancet Neurol. 2009; 8(11): 1019–1030.
  8. Chen LA, Cheng SJ, Jou SB. Epilepsy in the Elderly. International Journal of Gerontology. 2012; 6(2): 63–67.
  9. Ageing W. http://www. who. int/mediacentre/factsheets/fs404/en/ (Accessed September 2015).
  10. Eatock J, Baker GA. Managing patient adherence and quality of life in epilepsy. Neuropsychiatr Dis Treat. 2007; 3(1): 117–131.
  11. Sabaté E. Adherence to long-term therapies: evidence for action: Genava: World Health Organization. ; 2003.
  12. Stephen LJ, Brodie MJ. Epilepsy in elderly people. Lancet. 2000; 355(9213): 1441–1446.
  13. Sander JW. The use of antiepileptic drugs--principles and practice. Epilepsia. 2004; 45 Suppl 6: 28–34.
  14. van de Steeg N, Sielk M, Pentzek M, et al. Drug-adherence questionnaires not valid for patients taking blood-pressure-lowering drugs in a primary health care setting. J Eval Clin Pract. 2009; 15(3): 468–472.
  15. Tommelein E, Mehuys E, Van Tongelen I, et al. Accuracy of the Medication Adherence Report Scale (MARS-5) as a quantitative measure of adherence to inhalation medication in patients with COPD. Ann Pharmacother. 2014; 48(5): 589–595.
  16. Garcia-Marcos PW, Brand PLP, Kaptein AA, et al. Is the MARS questionnaire a reliable measure of medication adherence in childhood asthma? J Asthma. 2016; 53(10): 1085–1089.
  17. Hansen R, Seifeldin R, Noe L. Medication adherence in chronic disease: issues in posttransplant immunosuppression. Transplant Proc. 2007; 39(5): 1287–1300.
  18. Khanna R, Pace PF, Mahabaleshwarkar R, et al. Medication adherence among recipients with chronic diseases enrolled in a state Medicaid program. Popul Health Manag. 2012; 15(5): 253–260.
  19. Asadi-Pooya AA. Drug compliance of children and adolescents with epilepsy. Seizure. 2005; 14(6): 393–395.
  20. Jones RM, Butler JA, Thomas VA, et al. Adherence to treatment in patients with epilepsy: associations with seizure control and illness beliefs. Seizure. 2006; 15(7): 504–508.
  21. Saleem F, Hassali MA, Shafie AA, et al. Does treatment adherence correlates with health related quality of life? Findings from a cross sectional study. BMC Public Health. 2012; 12: 318.
  22. Liu J, Liu Z, Ding Hu, et al. Adherence to treatment and influencing factors in a sample of Chinese epilepsy patients. Epileptic Disord. 2013; 15(3): 289–294.
  23. Getnet A, Woldeyohannes SM, Bekana L, et al. Antiepileptic Drug Nonadherence and Its Predictors among People with Epilepsy. Behav Neurol. 2016; 2016: 3189108.
  24. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005; 353(5): 487–497.
  25. Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011; 26(3): 155–159.
  26. Pakpour AH, Gholami M, Esmaeili R, et al. A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence. Epilepsy Behav. 2015; 52(Pt A): 133–142.
  27. Gaitatzis A, Sander JW, Sander JW. The epidemiology of epilepsy revisited. Curr Opin Neurol. 2003; 16(2): 165–170.
  28. Kim S, Bennett K, Wallace E, et al. Measuring medication adherence in older community-dwelling patients with multimorbidity. European Journal of Clinical Pharmacology. 2017; 74(3): 357–364.
  29. Ahmad N, Othaman NI, Islahudin F. Medication adherence and quality of life in epilepsy patients. Int J Pharm PharmSci. 2013; 5: 401–4.
  30. Lin CY, Chen H, Pakpour AH. Correlation between adherence to antiepileptic drugs and quality of life in patients with epilepsy: A longitudinal study. Epilepsy Behav. 2016; 63: 103–108.
  31. Meador KJ, Gilliam FG, Kanner AM, et al. Cognitive and behavioral effects of antiepileptic drugs. Epilepsy Behav. 2001; 2(4): SS1–SS17.
  32. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010; 51(4): 676–685.
  33. Horne R, Weinman J. Self-regulation and Self-management in Asthma: Exploring The Role of Illness Perceptions and Treatment Beliefs in Explaining Non-adherence to Preventer Medication. Psychology & Health. 2002; 17(1): 17–32.
  34. Jónsdóttir H, Opjordsmoen S, Birkenaes AB, et al. Medication adherence in outpatients with severe mental disorders: relation between self-reports and serum level. J Clin Psychopharmacol. 2010; 30(2): 169–175.
  35. Baker GA, Smith DF, Jacoby A, et al. Liverpool Seizure Severity Scale revisited. Seizure. 1998; 7(3): 201–205.
  36. Affolter N, Krähenbühl S, Schlienger RG. Appropriateness of serum level determinations of antiepileptic drugs. Swiss Med Wkly. 2003; 133(43-44): 591–597.
  37. Cramer JA, Perrine K, Devinsky O, et al. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia. 1998; 39(1): 81–88.
  38. Mohammadi N, Kian S, Davoudi F, et al. Psychometric evaluation of the Persian version of the quality of life in epilepsy inventory-31. Iran J Neurol. 2013; 12(4): 144–148.
  39. Hu L, Bentler P. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal. 1999; 6(1): 1–55.
  40. Walters RJL, Hutchings AD, Smith DF, et al. Inappropriate requests for serum anti-epileptic drug levels in hospital practice. QJM. 2004; 97(6): 337–341.
  41. Harden CL, Maroof DA, Nikolov B, et al. The effect of seizure severity on quality of life in epilepsy. Epilepsy Behav. 2007; 11(2): 208–211.
  42. Bautista RE, Glen ET. Seizure severity is associated with quality of life independent of seizure frequency. Epilepsy Behav. 2009; 16(2): 325–329.
  43. Sancho J, Iváñez V, Molins A, et al. Changes in seizure severity and quality of life in patients with refractory partial epilepsy. Epilepsy Behav. 2010; 19(3): 409–413.
  44. Hovinga CA, Asato MR, Manjunath R, et al. Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: survey of patients with epilepsy and physicians. Epilepsy Behav. 2008; 13(2): 316–322.
  45. Martins H, Alonso N, Guilhoto L, et al. Adherence to treatment in patients with juvenile myoclonic epilepsy: correlation with quality of life and adverse effects of medication. Journal of Epilepsy and Clinical Neurophysiology. 2009; 15(4): 192–196.
  46. Alfian SD, Sukandar H, Lestari K, et al. Medication Adherence Contributes to an Improved Quality of Life in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Diabetes Ther. 2016; 7(4): 755–764.
  47. Loon SC, Jin J, Jin Goh M. The relationship between quality of life and adherence to medication in glaucoma patients in Singapore. J Glaucoma. 2015; 24(5): e36–e42.
  48. Martínez YV, Prado-Aguilar CA, Rascón-Pacheco RA, et al. Quality of life associated with treatment adherence in patients with type 2 diabetes: a cross-sectional study. BMC Health Serv Res. 2008; 8: 164.

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