Abstracts

Rationale:
Approximately 70% of epileptic patients can become seizure-free once effective medication regimens are established. Yet, medication adherence among epileptic patients is often suboptimal. Barriers with medication compliance are identified in the literature, including forgetfulness. Medication reminder apps and behavioral interventions are promising in helping patients with medication adherence with other chronic diseases. In the present study, we were determining if the use of a smartphone medication reminder app (Medisafe©) and an individualized behavioral intervention improves medication adherence among patients with epilepsy? The secondary aim was assessing the usability of both interventions.
Method:
A pilot, quasi-experimental study compared pre and post interventions results to determine interventions’ effectiveness using Morisky Medication Adherence Scale and a survey. Data were collected to assess interventions’ usability.  A convenience sample of 15 epileptic patients were recruited during their regular clinic visit at a Midwestern, university-affiliated, epilepsy center. The patients were recruited over a month. Those who met inclusion/exclusion criteria were accepted to participate in this study. The Medisafe® app was downloaded onto patients’ smartphones, anticonvulsant medications were compiled, and participants were educated on the use of the app. Medication barriers and ways to overcome barriers were determined during the clinic visit. Participants were instructed to use the app and practice the behavioral intervention (such as taking medication with meal, with coffee, or after brushing teeth; having a set of medication at work; carry a set of medication; etc.) for six weeks. Medication adherence was evaluated with the established Morisky Medication Adherence Scale, medication-taking history reports from Medisafe®, and usability feedback about interventions was assessed using the survey created for this project.
Results:
The primary outcome goal, to improve medication adherence as evidence by improved posttest on the Morisky Medication Adherence Scale, was significant (t=3.627, df=14, p=.003). Fourteen of the 15 patients reported the smartphone app as “helpful or very helpful”, Twelve participants reported the same with the behavioral intervention. Seizure activity was minimal during the four-week data collection period so could not be measured as an outcome.    
Conclusion:
Smartphone medication reminder apps and individualized behavioral interventions addressing medication barriers may increase adherence to anticonvulsant medications use with epileptic patients. Further studies with larger sample size and more extended monitoring periods are recommended.
Funding:
:There was no funding involved in this study.