Non-Adherence Raises Mortality Risk for Epilepsy Patients

Failure to take medication also raises risk of emergency department visits, hospital admissions

THURSDAY, June 19 (HealthDay News) -- Epilepsy patients who regularly fail to take their anti-epileptic drugs have increased risks of mortality and serious clinical events, according to a study published online June 18 in Neurology.

Edward Faught, M.D., of the University of Alabama at Birmingham Epilepsy Center, and colleagues performed a retrospective open-cohort study using Medicaid claims data from Florida, Iowa and New Jersey between January 1997 and June 2006. They studied 33,658 patients who were at least 18 years old, had at least one epilepsy diagnosis by a neurologist and had at least two anti-epileptic drug pharmacy dispensings. There was a non-adherence rate of 26 percent.

The researchers found that non-adherence to anti-epileptic drugs was associated with a more than threefold risk of mortality compared with adherence (hazard ratio, 3.32) after multivariate adjustments. In addition, time periods of non-adherence were associated with a significantly higher incidence of emergency department visits (incidence rate ratio, 1.5), hospital admissions (IRR, 1.86), motor vehicle accident injuries (IRR, 2.08) and fractures (IRR, 1.21) than periods of adherence.

"There are many reasons epileptic patients fail to take their seizure medications, including cost, side effects and pregnancy. But this study suggests that none of those reasons overshadow the threat of death or other problems related to uncontrolled seizures. Patients need to stay on their medications, and physicians need to recognize and treat issues related to people failing to take epilepsy drugs," Faught said in a statement.

The study was sponsored by GlaxoSmithKline. Faught and some co-authors report having financial ties to GlaxoSmithKline.

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