TUESDAY, April 26 (HealthDay News) -- Nearly three of every five
children diagnosed with epilepsy do not take their antiseizure
medicine as prescribed over the first six months of treatment, a
new study shows.
The pattern is usually established within the first month and
having a lower socioeconomic status raises the risk of
nonadherence, said study author Avani Modi, an assistant professor
of pediatrics at the University of Cincinnati College of Medicine
and Cincinnati Children's Hospital Medical Center.
"If they start well, they continue to do well," she said. "If they start not so well, they continue to do not so well."
The study is published in the April 27 issue of the
Journal of the American Medical Association.
According to the Epilepsy Foundation, the brain disorder affects
about 3 million Americans. There are 325,000 children under 15 with
epilepsy in the United States, according to background information
in the study.
While it's well-established among adults with epilepsy that not
taking medicine as recommended is linked with continued seizures
and other problems, less is known about the long-term and
short-term effects on children who don't take their medicines as
So, Modi looked at 124 children, aged 2 to 12, newly diagnosed
with epilepsy. The children's caregivers received a medicine bottle
with a special cap that electronically recorded when the bottle was
opened and closed, which allowed the investigators to monitor the
adherence to the drug prescribed.
The percentage of those not adhering -- 58 percent -- was a
surprise, said Modi, who had found a 20 percent noncompliance rate
in a previous study.
Only 42 percent had near perfect adherence, she found. The
others had early problems with adherence, either mild, moderate or
severe. Some had delayed problems with adherence, starting out well
but falling off.
The reasons for this may vary, Modi speculated. Some parents may
be in denial that their child has epilepsy. Some may think the risk
of the drug outweighs the risk of seizures. Some may fear adverse
But her data suggests that the frequency of seizures and adverse
events did not play a role in determining how well the children
adhered to the medication schedule.
Modi did find that the higher a family's socioeconomic status,
the more closely the children stuck to the medicine schedule.
For parents of newly diagnosed children, Modi said, one message
is to establish a medicine-taking routine early. If they establish
a routine from the start, she said, it will increase the chances of
She asks families: "Can you pair the medicine with things
already established?" For instance, if a child brushes his teeth at
8 a.m., establish that as medication time.
Modi has been a consultant for Novartis Pharmaceuticals Inc.,
which has an interest in anti-epileptic drugs.
The study results provide valuable information about how many
children don't take their epilepsy medication, said Dr. Orrin
Devinsky, director of the Comprehensive Epilepsy Center at the NYU
Langone Medical Center.
"Nonadherence is an important factor in poor seizure control for many children and adults with epilepsy," he said. "This study highlights both the high rate of nonadherence among children with newly diagnosed epilepsy and the very powerful role of socioeconomic status on predicting no adherence."
Doctors need to increase their efforts to educate parents and
patients about the need to stick to taking medicine as prescribed,
Obtaining information on the patterns of adherence is valuable,
said Dr. Michael Rapoff, the Ralph L. Smith Professor of Pediatrics
at the University of Kansas Medical Center in Kansas City.
Rapoff's area of research is on treatment adherence in children
with arthritis and asthma. "If this [new study result] holds up in
other studies, we will be able to identify early on what the
[pattern] is," he said.
The electronic monitoring used is "considered one of the most
objective ways of monitoring adherence," Rapoff added.
To learn more about epilepsy, visit the
U.S. National Institutes of Health.