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CC BY-NC-ND 4.0 · International Journal of Epilepsy 2017; 04(01): 046-050
DOI: 10.1016/j.ijep.2016.11.005
Research paper
Thieme Medical and Scientific Publishers Private Ltd.

Measurement and associative factors of adherence to epilepsy drug treatment among the elderly population in Tehran (Iran)

Reza Fadaye-Vatan
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
,
Ahmad Delbari
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
,
Elham Lotfalinezhad
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
b   Iranian Epilepsy Association, Tehran, Iran
,
Fatemeh Amini
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
b   Iranian Epilepsy Association, Tehran, Iran
,
Kurosh Gharagozli
b   Iranian Epilepsy Association, Tehran, Iran
c   Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Jafar Bolhari
b   Iranian Epilepsy Association, Tehran, Iran
d   Iran University of Medical Sciences, Faculty of Behavioral Sciences and Mental Health, Tehran, Iran
,
Parviz Bahrami
e   Department of Neurology, Lorestan University of Medical Sciences, Khorramabad, Iran
,
Vida Saii
b   Iranian Epilepsy Association, Tehran, Iran
,
Amir Ahmadi
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
,
Zahra Moghadam
f   Department of Public Health, Golestan University of Medical Science, Gorgan, Iran
,
Abdulaziz Aflakseir
g   Department of Clinical Psychology, University of Shiraz, Shiraz, Iran
,
Devender Bhalla
b   Iranian Epilepsy Association, Tehran, Iran
a   University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
› Author Affiliations
Further Information

Publication History

Received: 18 September 2016

Accepted: 23 November 2016

Publication Date:
06 May 2018 (online)

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Abstract

Purpose The objective of this survey was to measure adherence and to identify correlation and prediction factors related to noncompliance among the elderly in Tehran, Iran.

Methods A population-based survey was carried out among the elderly (≥60 years of age) by using Tehran Epilepsy registry. All subjects were contacted by telephone and invited for face-to-face consultation. Questionnaires used were the following: Medication Adherence Rating Scale (MARS); Medical Prescription Knowledge (MPK); Abbreviated Mental Test (AMT). Along with customary descriptive statistics, a simple chi-square test (or Fischer exact test if value of cells was ≤5) was used for correlating; Cramer's V was used for strength of association, and prediction was by logistic regression.

Results Out of 104 subjects’ approached, 23 subjects (median age 62.0, 95% CI 61.0–64.7, range 60–71; 73.9% males; 78.3% married and having a living partner; 54.5% epilepsy as supernatural; 21.7% with comorbid condition) participated. Most did not have a recent epilepsy onset (n = 20, 86.8%), or had active epilepsy (n = 22, 95.7%), convulsive seizures (n = 21, 91.3%), with no (n = 13, 56.5%) to low seizure number, and polytherapy (n = 12, 52.2%). Median MARS score was 8.0 (95% CI 6.0–8.0, range 3–10). Nonadherence was correlated to comorbidity (p = 0.003) and widowhood or divorcehood (p = 0.04) and predicted by the same factors. Treatment side effects altered behavior (p = 0.03), and unsteadiness (p = 0.01) was also associated with nonadherence. MPK was positive for all participants. Median AMT score was 9.0 (95% CI 9.0–10.0, range 6–10).

Conclusion Elderly patients had a high treatment adherence and, as logically expected, were associated with comorbid state, divorce-widowhood, and drug-related behavioral side effects particularly behavioral and unsteadiness.

Keywords

Anti-epileptic drugs - Compliance - Epilepsy - Elderly - Iran
 

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