Association of antiepileptic drug nonadherence with risk of seizures in adults with epilepsy
Manjunath, R., Davis, K. L., Candrilli, S. D., & Ettinger, A. B. (2009). Association of antiepileptic drug nonadherence with risk of seizures in adults with epilepsy. Epilepsy & Behavior, 14(2), 372-378. DOI: 10.1016/j.yebeh.2008.12.006
This study evaluated the potential effect of antiepileptic drug (AED) nonadherence on the risk of subsequent seizure. Retrospective insurance claims from the United States were analyzed. Inclusion criteria were: age 21-64 years, diagnosis of epilepsy or nonfebrile convulsions, >= 2 AED prescriptions, and insurance enrollment for >= 6 months pre- and >= 60 days post-AED initiation. Seizure was defined as a hospital or emergency admission associated with epilepsy OF nonfebrile convulsions. Observation began 7 days post-drug initiation, ending with the first of the following: seizure, insurance disenrollment, or 365 days post-drug initiation. Adherence was measured using the medication possession ratio (MPR), with MPR = 1 seizure. Mean follow-up was 133 days among subjects with event and 305 days for patients without event. Seizure risk was 21% higher among nonadherers (hazard ratio = 1.205, P = 0.0002) than adherers. (C) 2008 Elsevier Inc. All rights reserved.