Epilepsy Drug Nonadherence Tied to Socioeconomic Status

Higher nonadherence in newly diagnosed children of low socioeconomic status

TUESDAY, April 26 (HealthDay News) -- Adherence to antiepileptic drug therapy in children with newly diagnosed epilepsy varies greatly between children, and is significantly correlated with socioeconomic status, according to a study published in the April 27 issue of the Journal of the American Medical Association.

Avani C. Modi, Ph.D., from the Cincinnati Children's Hospital Medical Center, and colleagues identified and characterized trajectories of antiepileptic drug adherence during the first six months of therapy in 124 children, aged 2 to 12 years, with newly diagnosed epilepsy. The main outcome was objective adherence measured by electronic monitors, and sociodemographic and epilepsy-specific predictors of adherence were also assessed.

The investigators found that 58 percent of children showed persistent nonadherence during the first six months of treatment. Five differential adherence patterns were identified by group-based trajectory (Bayesian information criterion, −23611.8), which were established in most patients by the first month of treatment. Thirteen percent showed severe early nonadherence, 7 percent showed severe delayed nonadherence, 13 percent showed moderate nonadherence, 26 percent showed mild nonadherence, and 42 percent showed near-perfect adherence. The only predictor for adherence trajectory group status was socioeconomic status, with higher nonadherence correlating with lower socioeconomic status.

"Five trajectory patterns were identified that captured the spectrum of nonadherence to antiepileptic drugs among children with newly diagnosed epilepsy; the patterns were significantly associated with socioeconomic status," the authors write.

Two authors disclosed financial ties to pharmaceutical companies with interests in antiepileptic drugs, including Novartis Pharmaceuticals Inc., UCB Pharma, Eisai, Upsher-Smith, Lundbeck, Sunovion, Supernus, and Questcor.

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