McAuley JW, Passen N, Prusa C, Dixon J, Cotterman-Hart S, Shneker BF.  Epilepsy & Behavior, 43(2015): 61-65.

Taking seizure medications (called AEDs for antiepileptic drugs) regularly helps control seizures in about 2 out of 3 people with epilepsy. For the remaining 1 out of 3, AEDs may not control seizures but may help in some way. For example people may have less severe or frequent seizures. Yet taking medications is not easy and is influenced by many issues. Factors often reported by people with epilepsy that affect taking medications regularly includes memory and mood. 

Purpose

The authors, McAuley and colleagues, examined the impact of memory and mood on the adherence with AEDs (or ability to take seizure medications as prescribed) in people with epilepsy.

Description of Study

The study collected information from 100 adults with epilepsy who attended an outpatient neurology clinic in Ohio. People participating in the study had to be taking at least 1 AED for at least 6 months.

The researchers looked at the following information:

  • Memory tests. Items looked at how people reported their memory as well as objective tests of memory performance.
  • Mood.  A short questionnaire developed specifically to assess mood changes in people with epilepsy.
  • Self-reported medication adherence. A short questionnaire was used to look at each person’s perception of how well or regularly they were taking their seizure medication.
  • Medication refills. Looking at when people refilled their medication can give an objective measure of whether people take their medications as prescribed and on schedule. Pharmacy records for the prior 6 months were looked at for each person in the study.

Information was collected from each person once. This type of study gives a picture of how people take their medications and relationships with mood and memory but it does not look at the issues over time.

The majority of people in the study were females and most people had epilepsy for an average of 20 years. About 40% were taking one seizure medication and most people took their medications twice a day.

Summary of Study Findings

  • Most people rated themselves in the medium or high adherence category. This means they felt they were taking their medications pretty well or very well.
  • Most people did not report barriers or problems that affected their ability to take medications regularly. 10% felt that cost was a factor.
  • The most common factors that made taking medications easier include having a routine and using a pillbox.
  • No significant differences were found on memory tests between people who took their medications regularly (adherent group) and those that did not (non-adherent group). The memory scores did not appear to affect the prescription refill scores.
  • Most people rated themselves as having better memory, than was found using the objective memory tests. This means that people may not be aware of some memory problems.
  • Most people who were in the adherent group had better mood scores. People who were in the non-adherent group and thus had problems taking medications regularly had worse mood.
  • Patients who were seizure free were “more likely to be in the adherent group.” Seizure free in this study meant that a person had not had a seizure in the last year.

What does this mean?

This study looked at a common issue for people with epilepsy – taking medications regularly. Any person who takes medications daily knows how hard this can be. There are many factors that can affect this. The authors of this study looked at just a couple factors – mood, memory, and adherence or ways to assess how well a person takes their medications.  

A couple points are important to repeat and reinforce. People were not always a good judge of their memory. When memory was tested, more difficulties were found than had been reported by the individual. This has been found in other studies and in day-to-day life. A significant difference in mood was found between those who did not have problems taking medications (adherent group) and those that did have problems (non-adherent). Since information in this study was collected only once, the data gives us a snapshot of issues to pay attention to. Mood seems to be one that should be looked at in more detail.

Abstract:May 2015

Article published in Epilepsy & Behavior, February 2015