Medication Adherence in Individuals With Epilepsy
Medication Adherence in Individuals With Epilepsy
There is an urgent need to understand the psychological and situational factors that
 influence medication adherence in individuals with epilepsy. According to the Center for
 Disease Control (CDC, 2010) about 2.5 million people in the United States have epilepsy and
 one third of them still have seizures despite receiving treatment. With proper medication, an
 estimated 60-70% of individuals with new onset epilepsy become, and remain, seizure free
 (Kwan & Brodie, 2000). Despite the success of medical treatment of epilepsy, many patients do
 not receive these benefits due to inadequate adherence to medication (Meyer et al., 2010).
 And, as with other chronic medical conditions, estimates suggest that between 30% and 60% of
 patients with epilepsy are not adherent with their drug regimens (Green & Simons Morton,
 1988; Leppik, 1990; Jones et al., 2006). Poor adherence may be the most important cause of
 poorly controlled epilepsy (Gomes et al., 1998). Stanaway et al. (1985) found that 31% of
 seizures were precipitated by nonadherence to medication.

 Questions regarding adherence are theoretically informed by Fisher et al. (2006)'s
 Information Motivation Behavioral Skills (IMB) model. While originally developed to describe,
 predict, and inform interventions for antiretroviral treatment for human immunodeficiency
 virus (HIV), this study applies the model to epilepsy for the first time. In addition, this
 study intends to produce an accurate description of how individuals with epilepsy manage
 their medication adherence by identifying current self regulation strategies (immediate
 adherence behaviors, preparatory behaviors, and barrier management strategies) and their
 situational determinants. Situational determinants can explain some of the fluctuations in
 medication adherence. Patients who are motivated to take their medications might still show
 inconsistent medication adherence. For example, patients might miss good opportunities to
 take their medication or fail to anticipate unexpected barriers such as a spontaneous dinner
 with friends or a bout of depression. Therefore, the study will take particular care to
 investigate situational cues such as good opportunities for adherence (e.g., taking
 medication with regular meals or before brushing teeth) and expected and unexpected barriers.
 Preparatory behaviors and their cues are also of interest in this study: Some patients use
 facilitators (such as physical or electronic reminder systems, electronic pill bottles and
 pill boxes) to ensure adequate medication adherence. Social support can serve a similar
 function of reminding patients to take their medication. To address these questions, the
 investigators plan to explore how individual regulation and social support influence
 medication adherence in patients with epilepsy. The specific aims of the proposed research
 are:

 1. To test the hypothesis that there will be a main effect of information, motivation and
 behavioral skills, on adherence behavior, and that a mediation model will show that
 information and motivation effects are partially mediated through behavioral skills.

 2. To identify self regulation strategies and their situational cues (good opportunities,
 facilitators, and barriers) for medication adherence among individuals with epilepsy to
 better describe best practices and challenges.
Inclusion Criteria:

 -  Diagnosed with Epilepsy

 Exclusion Criteria:

 -  Age (under 18, over 65)