Adherence to antiepileptic drugs in children and adolescents: A retrospective study in primary care settings in Germany

• Published in: Epilepsy & behavior Vol. 75; pp. 36 - 41
• Main Authors: Jacob, Louis, Hamer, Hajo M., Kostev, Karel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2017
• Subjects: Adherence; Adolescent; Anticonvulsants - administration & dosage; Antiepileptic drugs; Child; Child, Preschool; Epilepsy - drug therapy; Epilepsy - epidemiology; Female; Germany; Germany - epidemiology; Humans; Male; Medication Adherence - statistics & numerical data; Pediatric practices; Primary Health Care - statistics & numerical data; Retrospective Studies; Adherence; Antiepileptic drugs; Pediatric practices; Germany
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2017.07.001

The goal of this study was to analyze adherence to antiepileptic drugs (AED) in children and adolescents treated in pediatric practices in Germany.
The present study included patients aged between 2 and 17years who were diagnosed with epilepsy (ICD-10: G40) and had received at least two prescriptions of AED between January 2006 and December 2015 in 243 pediatric practices in Germany. The medication possession ratio (MPR) was used to estimate adherence, and patients with a MPR greater than 80% were considered adherent. The impact of patient and drug characteristics on adherence was analyzed using a multivariate logistic regression model.
A total of 5214 patients were included. Mean age was 10.9years (SD=4.9years). The overall MPR was 88.8% (SD=34.1%), and 68.9% of patients were considered adherent. Children aged 5years or younger were more adherent to AED than those aged between 14 and 17years (OR=1.22, 95% CI: 1.07–1.39). Individuals living in western Germany were also found to be more adherent than those living in eastern Germany (OR=1.71, 95% CI: 1.55–1.88). Asthma as a comorbidity (OR=1.59, 95% CI: 1.29–1.96) was positively and attention-deficit hyperactivity disorder (OR=0.81, 95% CI: 0.71–0.93) negatively associated with treatment adherence. Finally, no significant association was found between adherence and the type of AED.
Two-thirds of children and adolescents suffering from epilepsy in Germany were adherent to AED. Age, place of residence, and comorbidities were significantly associated with adherence.
•There were 68% of children and adolescents with epilepsy who were adherent to antiepileptic drugs.•Children ≤5years of age were more adherent to AED than those aged 14–17years.•Asthma was positively associated with treatment adherence.•Attention-deficit hyperactivity disorder was negatively associated with treatment adherence.