%0 Journal Article
%T Identification and Prevention of Antiepileptic Drug Noncompliance: The Collaborative Use of State-Supplied Pharmaceutical Data
%A Joseph C. Hodges
%A Janet Treadwell
%A Amy D. Malphrus
%A Xuan G. Tran
%A Angelo P. Giardino
%J ISRN Pediatrics
%D 2014
%R 10.1155/2014/734689
%X Background. Antiepileptic drugs (AEDs) noncompliance is associated with increased risk of seizures and morbidity in seizure disorder patients. Objective. To identify risk factors that correlated to higher levels of morbidity, measured by emergency room (ER) utilization by seizure disorder members taking AED. Methods. Patients with primary or secondary diagnosis of seizures, convulsions, and/or epilepsy and prescribed AEDs during an 11-month period were included in the study. Variables were analyzed using multivariate statistical analysis including logistic regression. Results. The study identified 201 members. No statistical significance (NS) between age, gender, number of tablets, type of drug, or other risk factors was associated with increased mortality. Statistical significance resulted with medication compliance review of 0¨C14 days, 15¨C60 days, and 61+ days between refills. 68% of patients with ER visit had noncompliance refill between 0 and 14 days compared to 52% of patients in non-ER group ( ). Contrastingly, 15% of ER group had refills within 15¨C60 days compared with 33% of non-ER group ( ). There was NS difference between two groups when noncompliance was greater than 60 days ( ). Conclusions. The study suggests that careful monitoring of pharmaceutical refill information could be used to identify AED noncompliance in epileptic patients. 1. Introduction Seizures are the most common pediatric neurological disorder. Of the roughly 150,000 children who experience a first-time seizure, it has been estimated that 30,000 will suffer from epilepsy [1, 2]. The terms seizure and convulsion are commonly used interchangeably, but for the purposes of this report we will simply use the term seizure [3]. Furthermore, the terminology of epilepsy and convulsive and/or seizure disorder used in this study is meant to be as inclusive as possible due to the fact that the accuracy of distinguishing an epilepsy diagnosis in the presence of seizures has been reported to range from 5% to 23% [4]. Regardless of the specific diagnosis, antiepileptic drug (AED) therapy is a hallmark therapeutic approach and the importance of adherence to AED regimes has largely been demonstrated to affect a patient¡¯s risk of future seizures [5]. Several studies have explored various risk factors and their association with AED noncompliance. Clearly, it has been shown that AED noncompliance increases a patient¡¯s risk for further seizure activity [5¨C9]. Furthermore poor seizure control has been linked to an increase in morbidity and mortality for patients [10, 11]. Several of these
%U http://www.hindawi.com/journals/isrn.pediatrics/2014/734689/