Adherence of anti-epileptic drugs in pediatric patients in Taiwan

• Main Authors: Shih-ChiehShao, 邵時傑
• Other Authors: Yea-Huei Kao
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/29845571735688708256

碩士 === 國立成功大學 === 臨床藥學與藥物科技研究所 === 100 === Background: Regarding poor adherence may lead to poor seizure control or mortality, patients are diagnosed with epilepsy are suggested to be adherent to anti-epileptic drugs (AEDs) regimen for at least two years. However, the information on AEDs adherence in pediatric patients with epilepsy remained insufficient nowadays. Purpose: This study aimed to investigate the trend of adherence of AEDs and factors associated with adherence in pediatric patients within one-year period after epilepsy was newly diagnosed. Methods: We conducted a retrospective cohort study by using claims data which contained one third pediatric patients randomly sampled from Taiwan National Health Insurance Research Database (NHIRD) in the year 2006 and 2007. Patients were aged 18 or less, newly diagnosed with epilepsy (ICD-9: 345.xx), and received more than two AEDs prescriptions (ATC code: N03A, N05BA09). Patients were followed one year from index date to measure the adherence of AEDs using the medication possession ratio (MPR), and non-adherence was defined as MPR less than 0.8. We evaluated factors associated with adherence by using multivariate logistic regression including patient demographics, comorbidities and index drug. Results: 424 patients were identified with 54.3% of male patients nd the mean age of epilepsy diagnosed was 9.9±4.9 years. MPR was decreased with time. The one-year mean MPR was 0.62, and 58.7% of patients were non-adherent. The factor associarted with adherence was receiving newer AEDs initially. Compared to old AEDs, receiving newer AEDs initially had significantly lower non-adherence risk (multivariate OR: 0.44, 95% CI: 0.23, 0.83). Conclusion: The first one-year AEDs adherence in pediatrics newly diagnosed with epilepsy was suboptimal, and patients received new AEDs initially had significantly lower non-adherence risk. However, it still needs further studies to investigate the impact of this finding.