Compliance with treatment in child patients with epilepsy and factors affecting compliance with treatment

Objective: The aim is to determine medication compliance rates in children with epilepsy who are followed up at Balıkesir University Health Application and Research Center Child Neurology outpatient clinic, to identify the factors affecting medication compliance, to take measures to minimize medication non-compliance, and thus to prevent correctable negativities due to epilepsy. Materials and Methods: The research is a cross-sectional descriptive research. Similar studies in the literature were used in the design of this study. Among 380 patients who were followed up with a diagnosis of epilepsy at Balıkesir University Health Application and Research Center Child Neurology Polyclinic, 150 patients whose families agreed to participate in the study were included in the study. The study was conducted by applying the questionnaire prepared to determine the compliance of patients applying to Balıkesir University Health Application and Research Center Child Neurology Polyclinic to anti-seizure treatment and the factors affecting compliance, to the patients and their caregivers. The survey questions used in the study were prepared by revising the survey questions in similar studies in the literature. The survey form to be used in the study consists of 5 (five) sections in which the sociodemographic characteristics of the patients, the sociodemographic characteristics of their parents, the patients' clinical information about epilepsy, the MMSA-8 (Morisky Treatment Compliance Scale) Survey and the evaluation of the level of compliance with the prohibitions are investigated. A total of 2 surveys were created: a 53-question survey for adolescent patients who can take their own anti-seizure medications, and a 49-question survey for pediatric patients who are given anti-seizure medications by their caregivers. Results: 150 patients diagnosed with epilepsy and using anti-seizure treatment were included in the study. Of the patients included in the study, 80 (53.33%) were children and 70 (46.67%) were adolescents. Considering the gender distribution of the patients; 74 (49.3%) were women and 76 (50.67%) were men. The mean age of all patients was 10.69±5 years, and the median age was 11 (7-15) years. While 21 (14%) of the patients were diagnosed with epilepsy in the last year; 56 patients (37.33%) had been diagnosed with epilepsy for 1-3 years, 40 patients (26.67%) for 3-5 years, and 26 patients (17.33%) for 5-10 years. While 66 patients (44%) had a seizure in the last year, 84 patients (56%) had their last seizure more than 1 year ago. 112 patients (74.67%) were using a single antiepileptic drug (monotherapy); 38 patients (25.33%) were using two or more antiepileptic drugs (polytherapy). When we look at the most used antiepileptic drugs; 95 patients (48.72%) were using levetiracetam and 49 patients (25.13%) were using valproic acid. When the answers to the MMSA8 survey questions are examined; The average of the MMSA8 survey, which was evaluated out of a total of 8 points, was 6.65±2 and the median value was 7 (6-8). A statistically significant relationship was found between the MMSA8 score and the patient group (p = 0.002). Adolescents have lower MMSA scores. A statistically significant relationship was found between the MMSA8 score and the number of patient's neurology outpatient clinic visits (p=0.008), and the MMSA score was found to be higher in patients who went for regular check-ups. A statistically significant relationship was observed between MMSA8 score and epilepsy diagnosis time (p=0.003). Patients with shorter epilepsy diagnosis time had higher MMSA scores. Conclusion: Epilepsy is the most common chronic neurological disease in the world, and there are approximately 10.5 million children diagnosed with epilepsy in the world. When the studies are examined, it has been reported that patients diagnosed with epilepsy have a lower quality of life than healthy individuals. Recurrence of seizures is unpredictable and poses a constant danger to children with epilepsy and their families, especially if they do not comply with their medication regimen. The most common cause of recurrent seizures in children with epilepsy is non-compliance with prescribed anti-seizure medication. Non-compliance with treatment increases the number of hospital readmissions, morbidity and mortality of patients. In our study, the average score obtained from the MMSA-8 scale was 6.65±2, and we found that 24% of the patients had low compliance, 32% had moderate compliance, and 44% had high compliance with the treatment. Medication incompatibility; We found that it was related to the patient's age, duration of epilepsy diagnosis, duration of anti-seizure medication use, lack of regular attendance at neurology outpatient clinic checks, increased number of siblings, communication with the doctor, and support from the social environment. As a result, in chronic diseases such as epilepsy, compliance with treatment determines the course of the disease. Non-compliance with anti-seizure treatment harms the expected outcome of treatment and causes worsening prognosis or mortality. For this reason, we think that treatment compliance rates of children diagnosed with epilepsy should be determined and the factors affecting this should be investigated. Thus, we believe that more success will be achieved in the treatment of epilepsy by taking measures to minimize treatment noncompliance.