Adherence to antiepileptic drugs in children with epilepsy in a Scottish population cohort

Aim: To measure the adherence to antiepileptic drugs (AED) in a population cohort of children with epilepsy and to study the relationship between adherence and a series of clinical variables. Method: A population-based study of children (<16y) with epilepsy on AED treatment from the Tayside region of Scotland during two epochs of 12 months each. A clinical database was constructed using hospital records and linked to a community dispensing pharmacy database to calculate an Adherence Index. The principal outcome measure was the measurement of population-based adherence to AEDs. Secondary outcome measures were the association of adherence with the clinical characteristics of the population. Results: The median age of study group was 10 years and the median duration of epilepsy was 4 years. Only 30.9% of the total 320 children adhered to recommended AED treatment (Adherence Index >90%) across a year of treatment. Twenty-five percent of children had an Adherence Index of less than 50%. Adherence declined with increasing age. There was no significant correlation between adherence and other clinical characteristics studied (sex, duration of epilepsy, other comorbid health problems, other regular medications, and seizure frequency). Interpretation: Our data shows adherence to AED treatment is poor in children with epilepsy. What this paper adds: Demonstrates poor adherence to antiepileptic drugs treatment in childhood epilepsy.