Factors associated with treatment non-adherence in patients with epilepsy in Brazil

PURPOSE To investigate factors associated with treatment non-adherence in Brazilian patients with epilepsy. METHODS Prospective cross-sectional study. We evaluated 385 epilepsy outpatients in a tertiary referral center, 18 years or older, literate, without cognitive impairment or active psychiatric disorders, who were independent in daily living activities. Data were analyzed with correlation tests and conjoint analysis using multivariate logistic regression. RESULTS Non-adherence rate, measured by the Morisky-Green Test, was 66.2%, a moderate-to-low adherence level. Non-adherence was higher in men, in younger patients and in patients with uncontrolled seizures. Increasing treatment complexity was also associated with decreased treatment adherence. CONCLUSION Strategies designed to improve treatment adherence should address peculiarities associated with younger ages and male gender. Physicians should be made aware that prescription of less complex treatment regimens may result in better treatment adherence, and, therefore, better seizure control. The challenge in adjusting AED treatment in this population is to minimize treatment complexity, thus increasing chances for treatment adherence.