Association of antiseizure medication adherence with illness perceptions in adults with epilepsy.
Autor: | Choi H; Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. Electronic address: hc323@cumc.columbia.edu., Wetmore JB; Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: jbw2167@cumc.columbia.edu., Camarillo IA; Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA. Electronic address: iac2112@cumc.columbia.edu., Misiewicz S; Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA. Electronic address: sn2315@cumc.columbia.edu., Siegel K; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: ks420@cumc.columbia.edu., Chung WK; Departments of Pediatrics and Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. Electronic address: wkc15@cumc.columbia.edu., Leu CS; Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: cl94@cumc.columbia.edu., Phelan JC; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: jcp13@cumc.columbia.edu., Yang LH; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA; School of Global Public Health, New York University, New York, NY, USA. Electronic address: ly1067@nyu.edu., Ottman R; Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA; Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA. Electronic address: ro6@columbia.edu. |
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Jazyk: | angličtina |
Zdroj: | Epilepsy & behavior : E&B [Epilepsy Behav] 2023 Aug; Vol. 145, pp. 109289. Date of Electronic Publication: 2023 Jun 12. |
DOI: | 10.1016/j.yebeh.2023.109289 |
Abstrakt: | Objective: We assessed the relationship of epilepsy illness perceptions to antiseizure medication (ASM) adherence. Methods: Surveys were completed by 644 adult patients with epilepsy of unknown cause. We used the Morisky Medication Adherence Scale-8 (MMAS-8) to define "high" adherence (score = 8) and "low-medium" adherence (score < 8). We evaluated epilepsy illness perceptions using seven items from the Brief Illness Perception Questionnaire (BIPQ), each scored from 0-10, measuring participants' views of the overall effect of epilepsy on their lives, how long it would last, how much control they had over their epilepsy, the effectiveness of their treatment, level of concern about epilepsy, level of understanding of epilepsy, and emotional impact of epilepsy. We investigated the association of each BIPQ item with medication adherence using logistic regression models that controlled for potential confounders (age, race/ethnicity, income, and time since the last seizure). Results: One hundred forty-nine patients (23%) gave responses indicating high adherence. In the adjusted models, for each 1-unit increase in participants' BIPQ item scores, the odds of high adherence increased by 17% for understanding of their epilepsy (OR = 1.17, 95% CI 1.07-1.27, p < 0.001), decreased by 11% for overall life impact of epilepsy (OR = 0.89, 95% CI 0.82-0.97, p = 0.01) and decreased by 6% for emotional impact of epilepsy (OR = 0.94, 95% CI 0.86-0.99, p = 0.03). No other illness perception was associated with high adherence. Depression, anxiety, and stigma mediated the inverse relationships of high adherence to the overall life impact of epilepsy and the emotional impact of epilepsy. These measures did not mediate the relationship of high adherence to the perceived understanding of epilepsy. Conclusion: These results indicate that a greater perceived understanding of epilepsy is independently associated with high ASM adherence. Programs aimed at improving patients' understanding of their epilepsy may help improve medication adherence. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
Databáze: | MEDLINE |
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