Medication adherence, utilization of healthcare services, and mortality of patients with epilepsy on opiate replacement therapy: A retrospective cohort study

Introduction Substance misuse is not uncommonly recognized in people with epilepsy (PWE). Mortality significantly greater those comorbid substance misuse, but it remains unclear whether care and management contribute to this. This cohort study aimed compare the rates of mortality PWE receiving opiate replacement therapy (ORT) alone, as well evaluate their medication adherence, levels engagement services currently delivered, utilization unscheduled hospital care. Material methods A 5-year historical for was identified manually validated using electronic patient records registered NHS Tayside. Overall incidence contact emergency health were calculated ORT alone. Engagement outpatient also noted. Adherence antiepileptic drugs (AEDs) expressed terms possession ratio (MPR). Results Of 1297 attending a tertiary service, 68 (5.3%) ORT. The rate on comparison only (7.4% vs 1.7 %; P < 0.05; relative risk death: 4.34, 95% CI 1.19–15.7), healthcare being higher (24.5% 17.7%; ratio: 1.39, CI: 1.12–1.71). Poor adherence AEDs more common (28.4% 23.5%; = 0.02), failure engage elective (8.4% 3.0%; 2.77, 1.86–4.1). Conclusion People are less likely delivered or take prescribed despite most these patients having daily attendance at community pharmacist. may increased Clinicians policymakers should consider service redesign meet demands this high-risk population an attempt reduce morbidity