Developing a method to identify medicines non-adherence in a community sample of adults with epilepsy

The aim is to propose a simple way of identifying patients at risk of antiepileptic drug (AED) non-adherence during epilepsy review (a scheduled consultation to review the patient and their condition). The use of a multi-modal approach to the problem of non-adherence is necessary because of the limitations of existing methods.A mixed methodology was developed in a nested study using a case record review to calculate the medicine possession ratio (MPR) from the AED medication records of a community sample, a literature review and a consensus panel to develop a questionnaire to address how people manage their epilepsy, particularly medicine management, and how to collect information about non-adherence through stated findings in keeping with non-adherent behavior.Results show that a medicine record can be used to estimate the MPR (< 80% indicates non-adherence) and that an open and non-confrontational consultation style can be fostered by using key questions within the consultation to identify those at risk of non-adherence.

► An accessible structured medicines record is crucial for calculation of MPR. ► Non-adherence is dynamic, can affect all and be identified at epilepsy review. ► Adopt a non-confrontational consultation style using key questions at review. ► A multi-modal approach to non-adherence is needed; any one method has limitations. ► This study can be implemented with little extra health resource.