Objective: Non-adherence to antiepileptic drugs (AEDs) is a source of preventable seizures, morbidity, and mortality in patients with epilepsy (PWE). Prospective Memory (ProM), or memory for intentions, has been linked to adherence in chronic illnesses; its relevance to medication management in epilepsy has been largely unexplored. We hypothesized that ProM deficits would be associated with suboptimal AED adherence. Method: Ethnically diverse PWE (N = 51; 57% Female; 57% African-American, 24% Caribbean-American, 22% Latino) completed a ProM measure (Memory for Intentions Screening Test; MIST) and had AED adherence electronically monitored for one-month (Medication Event Monitoring System; MEMS). MIST performance and MEMS results were characterized, and their relationships were examined using (one-tailed) Spearman correlations. Results: On average, participants took AEDs as prescribed 72% of the time (SD = 27.6); 88% of participants missed ≥1 dose and 52% took ≥1 extra dose. MIST Total Scores indicated borderline impaired ProM (Mean Z-Score = −1.63, SD = 2.23) and were significantly correlated with frequency of extra doses taken (rs = −.25, p = .041). Performance on MIST's 24-hour delayed ProM task was also significantly associated with frequency of extra doses (rs = −.31, p = .012). Patients who failed the 24-hour delayed ProM task were AED-adherent 69% of the time, whereas those with full or partial scores displayed 80% adherence. Conclusion: Findings revealed ProM deficiencies in PWE, which were associated with suboptimal AED adherence. ProM assessments, such as MIST's 24-hour delayed ProM task, may offer practical means of identifying individuals at risk of AED non-adherence. Ethnic minority PWE, who are at risk for poor health outcomes, may especially benefit from ProM evaluation and intervention.
Prospective Memory Performance is Associated with Antiepileptic Drug Adherence in Ethnically Diverse Patients with Epilepsy
L Nakhutina, S Margolis, J Gonzalez, G Chen, A Medina, A Grant; C-41
Prospective Memory Performance is Associated with Antiepileptic Drug Adherence in Ethnically Diverse Patients with Epilepsy. Arch Clin Neuropsychol 2015; 30 (6): 577-578. doi: 10.1093/arclin/acv047.243
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