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)

  

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.