Key predictors of the need for a family-focused pediatric epilepsy adherence intervention.

Creator(s)

Dana Bakula, Children's Mercy HospitalFollow
Katherine W. Junger
Shanna M. Guilfoyle
Constance A. Mara
Avani C. Modi

Document Type

Article

Publication Date

8-2022

Identifier

DOI: 10.1111/epi.17302

Abstract

OBJECTIVE: Nonadherence to antiseizure drugs is a significant problem in pediatric epilepsy and is linked to increased morbidity and mortality, clinically unnecessary medication changes, and increased health care costs. Family interventions can improve adherence. However, it is challenging to determine which families will struggle with nonadherence and require intervention. This study aims to identify specific parent, family, child, and medical factors that predict which families most need family-based adherence interventions.

METHODS: Families enrolled in a randomized clinical trial of a family-based adherence intervention completed measures assessing parent, family, child, and medical factors. Families also used an electronic adherence monitor. Adherence of ≥95% was considered high adherence (not requiring intervention), and

RESULTS: Of the 200 families of children with new onset epilepsy who enrolled, 177 families completed the study. Of these families, 121 (68%) were in the high adherence group and 56 (32%) were in the suboptimal adherence group. Families with lower socioeconomic status (SES), children of color, lower general family functioning, and more parent distress were more likely to be in the suboptimal adherence group.

SIGNIFICANCE: We identified that parent and family factors, as well as sociodemographic characteristics, predicted membership in the suboptimal adherence group. It is critical to find creative and practical solutions for assessing and intervening upon key adherence predictors. These may include streamlined screening for parental distress and family functioning, as well as recognition that families of lower SES and communities of color may be at heightened risk for suboptimal adherence.

Journal Title

Epilepsia

Volume

63

Issue

8

First Page

2120

Last Page

2129

MeSH Keywords

Child; Epilepsy; Family; Humans; Medication Adherence; Parents; Social Class

Keywords

adherence; epilepsy; family functioning; race; socioeconomic status

Comments

Grant support

• R01HD073115/Eunice Kennedy Shriver National Institute of Child Health and Human Development

Recommended Citation

Bakula DM, Junger KW, Guilfoyle SM, Mara CA, Modi AC. Key predictors of the need for a family-focused pediatric epilepsy adherence intervention. Epilepsia. 2022;63(8):2120-2129. doi:10.1111/epi.17302