Forgetting to take antiseizure medications is associated with focal to bilateral tonic-clonic seizures, as revealed by a cross-sectional study.
Forgetting to take antiseizure medications is associated with focal to bilateral tonic-clonic seizures, as revealed by a cross-sectional study.
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DOI：
10.1371/journal.pone.0240082
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Ochi S
中科院分区：
文献类型：
--
作者：
Suzuki H;Mikuni N;Ohnishi H;Yokoyama R;Enatsu R;Ochi S
为了评估不依从抗癫痫药物（ASMs）和临床特征对癫痫控制的影响，我们采用了一项前瞻性队列横断面研究，使用癫痫患者（PWE）的自我报告和医疗记录。从2018年1月至2019年3月，从14家合作门诊诊所招募了855名服用ASM的PWE。来自Morisky药物依从性量表的问题被用作依从性自我报告。如果PWE的调查问卷表明他们错过了ASMs的剂量，门诊医生直接询问他们的依从性细节，包括有意或无意错过剂量的时间。通过单变量和多变量分析评估癫痫发作控制不足和使用结局（如漏服剂量、人口统计学和PWE的临床特征）之间的相关性。多变量分析显示，忘记服用ASMs与癫痫发作控制不足和存在局灶性至双侧强直阵挛性癫痫发作相关。老年痴呆症，年龄较小，使用三种或三种以上抗癫痫药物，以及生活在一个人的家庭与忘记服用ASMs的风险有关。对于药物管理不良或ASM漏服率高的PWE，努力提高依从性可促进更好的癫痫控制，并减少局灶性双侧强直阵挛传播。
To evaluate the effects of nonadherence to antiseizure medications (ASMs) and clinical characteristics on seizure control, we employed a prospective cohort cross-sectional study using self-reports and medical records of patients with epilepsy (PWEs). Eight hundred and fifty-five PWEs taking ASMs were enrolled from fourteen collaborative outpatient clinics from January 2018 to March 2019. Questions from the Morisky Medication Adherence Scale were used as adherence self-reports. If a PWE’s questionnaire indicated that they had missed doses of their ASMs, outpatient physicians asked them directly about the details of their compliance, including the timing of intentionally or unintentionally missed doses. The association between lack of seizure control and utilization outcomes, such as missed doses, demographics, and clinical characteristics of the PWEs, were assessed by univariate and multivariate analyses. Multivariate analysis revealed that forgetting to take ASMs was associated with lack of seizure control and the existence of focal to bilateral tonic–clonic seizures. Dementia, younger age, use of three or more antiepileptic agents, and living in a one-person household were associated with the risk of forgetting to take ASMs. For PWEs with poor drug management or a high incidence of missed doses of ASMs, efforts to improve adherence could facilitate better seizure control and decrease focal to bilateral tonic–clonic propagation.
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影响因子：
3.4
作者：
Willems LM;Watermann N;Richter S;Kay L;Hermsen AM;Knake S;Rosenow F;Strzelczyk A
通讯作者：
Strzelczyk A
影响因子：
2.6
作者：
Sweileh, Waleed M.;Ihbesheh, Manal S.;Morisky, Donald E.
通讯作者：
Morisky, Donald E.
影响因子：
2.3
作者：
Coleman, Craig I.;Sobieraj, Diana M.;Marinucci, Lawrence N.
通讯作者：
Marinucci, Lawrence N.
影响因子：
2.6
作者：
Manjunath, Ranjani;Davis, Keith L.;Ettinger, Alan B.
通讯作者：
Ettinger, Alan B.
影响因子：
2.6
作者：
Tombini, Mario;Assenza, Giovanni;Di Lazzaro, Vincenzo
通讯作者：
Di Lazzaro, Vincenzo