Abstracts

Rationale: The prevalence of nonadherence to antiseizure medication (ASM) in epilepsy is high, contributing to incomplete seizure control. Identification of modifiable factors predictive of good adherence can inform interventions to enhance clinical care. Patient perceptions of their illness have been linked with medication adherence in other chronic diseases such as hypertension and asthma. We assessed the association between ASM adherence and illness perceptions in epilepsy.

Methods: A self-administered survey was completed by 457 adults (63% women, mean age 41 years, range 19-79) treated for epilepsy at Columbia University Irving Medical Center. We assessed medication adherence with the Morisky Medication Adherence Scale-8 (MMAS-8). To explore factors associated with high medication adherence, we compared those with good adherence (MMAS-8 score of 8) with those with medium or poor adherence (score < 8). We used the Brief Illness Perception Questionnaire (BIPQ) to assess patients’ cognitive and emotional representations of epilepsy on an 11-point (score 0-10) scale. We selected seven dimensions of epilepsy illness perceptions: effects on daily life, perceived duration, personal control, belief in treatment efficacy, concerns, understanding, and emotional response. A higher BIPQ score reflects a view of the illness as more threatening. We assessed associations of good adherence with patient demographics, clinical epilepsy factors, and illness perceptions, using the chi-square test or Fisher’s exact test for proportions and the two-tailed t-test for means. Factors associated with good adherence in the bivariate analysis at a liberal p-value (p < 0.2) were included in a multivariate logistic regression to identify factors independently associated with good adherence. We analyzed associations with each of the seven BIPQ items on medication adherence individually.