Highlights
- •Adolescents are at heightened risk of suboptimal ASM adherence.
- •Higher motivation predicted higher objective ASM adherence.
- •Motivation may be an important target of adolescent ASM adherence interventions.
Abstract
Objective
Adolescents with epilepsy are at heightened risk for suboptimal anti-seizure medication
(ASM) adherence; however, there is a paucity of adherence interventions for this age
group. The current study aimed to identify a comprehensive and novel set of predictors
of objective, electronically-monitored ASM adherence in adolescents with epilepsy.
Methods
Participants included 104 adolescents (13–17 years old; M = 15.36 ± 1.40), diagnosed with epilepsy and their caregivers. Cross-sectional data
were collected from adolescents, caregivers, healthcare providers, and medical chart
reviews, including demographics (i.e., age, race/ethnicity, sex, insurance status),
the COVID-19 pandemic (i.e., participation before versus during), seizure characteristics
(i.e., presence and severity), ASM side effects (Pediatric Epilepsy Side Effects Questionnaire),
adherence motivation (1-item 6-point Likert scale item), and adherence barriers (Pediatric
Epilepsy Medication Self-Management Questionnaire). Electronically-monitored adherence
data was collected via the AdhereTechTM pill bottle or the Vaica SimpleMedTM pillbox over 30 days.
Results
Adolescents demonstrated suboptimal adherence at 78 ± 31.6%, despite high ASM adherence
motivation (M = 4.43 ± .94) and minimal adherence barriers (M = 35.64 ± 3.78). Hierarchical multiple regression, which included non-modifiable
sociodemographic and medical variables (Block 1) and behaviorally modifiable psychosocial
variables (Block 2) was significant, F(12,87) = 3.69, p < .001. Specifically, having private insurance (versus Medicaid or public insurance;
t = −2.11, p = .038) and higher adherence motivation (t = 2.91, p = .005) predicted higher objective ASM adherence.
Conclusion
Routine assessment of adherence predictors is vital for the promotion of adherence
among adolescents with epilepsy. Adolescent adherence motivation may be an important
element of multi-component interventions focused on improving ASM adherence in adolescents
with epilepsy.
Keywords
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Article info
Publication history
Published online: April 15, 2023
Accepted:
March 23,
2023
Received in revised form:
March 21,
2023
Received:
December 22,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
