Clear communication with the patient provides the basis for an effective patient-physician partnership, and noncompliance often results from a failure in communication. But even when the physician has given clear instructions and stressed the importance of following the medication regimen, noncompliance is the most common reason for incomplete seizure control or variable side effects.
Up to half of patients with epilepsy may not take their antiepileptic drugs (AEDs) as directed, and over half of the patients seen in emergency rooms because of recurrent seizures are noncompliant. Both patient-related and iatrogenic factors may be responsible.
Patient-related factors that increase noncompliance are:
Iatrogenic factors include:
Noncompliance should be suspected if there is:
Monitoring AED levels will help determine compliance. However, patients who are compliant with the regimen also may have low or variable serum levels if:
Reviewed and revised December 2003 by Steven C. Schachter, MD, Harvard Medical School
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