Strategies for improving adherence to antiepileptic drug treatment in people with epilepsy

摘要: Background Poor adherence to antiepileptic medication is associated with increased mortality, morbidity and healthcare costs. In this review, we focus on interventions designed tested in randomised controlled trials quasi-randomised assist people medication. This an updated version of the original Cochrane review published Library, Issue 1, 2010. Objectives To determine effectiveness aimed at improving adults children epilepsy. Search methods For latest update, 4 February 2016 searched Epilepsy Group Specialized Register, Central Register Controlled Trials (CENTRAL) via Studies Online (CRSO), MEDLINE (Ovid 1946 2016), CINAHL Plus (EBSCOhost 1937 PsycINFO 1887 ClinicalTrials.gov, WHO International Clinical Registry Platform. We also reference lists relevant articles. Selection criteria Randomised adherence-enhancing a clinical diagnosis epilepsy (as defined individual studies), any age treated drugs primary care, outpatient or other community setting. Data collection analysis All authors independently assessed potentially citations abstracts. At least two extracted data performed quality assessment each study according tool for assessing risk bias. graded level evidence outcome GRADE working group scale.The studies differed widely type intervention measures adherence; therefore combining was not appropriate. Main results We included 12 reporting 1642 participants (intervention = 833, control 809). Eight targeted epilepsy, one all ages, older than years, caregivers families epilepsy. identified six ongoing trials. Follow-up time generally short most trials, ranging from months. The examined three main types interventions: educational interventions, behavioural mixed interventions. All compared treatment versus usual care 'no intervention', except studies. Due heterogeneity between terms methods used measure way were reported, did pool results these findings inappropriate be meta-analysis. Education counselling resulted success (moderate-quality evidence). Behavioural such as use intensive reminders provided more favourable effects effect described by showed improved groups (high-quality evidence). Authors' conclusions Behavioural reminders and demonstrate some positive results; however, need reliable their efficacy, derived carefully-designed before can draw firm conclusion. Since last none new have additional information that would lead significant changes our conclusions. current update includes studies, which came searches.