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Authors : Widyati, Soediatmoko, Dian Maria, Zullies Ikawati, Lukman Hakim
Abstract : Study aims were (1) to document adherence measurement using 3 different methods. (2) to determine the relationship between each methods. The study wasconducted using cross sectional design. Patients were followed-up for 6 months and adherences weremeasured after 1 and 6 months therapy. The methods used to measure the adherenceswere 1) Patient/parent-self reported ( MMAS-8 questionnaires); 2) Drug level assay and 3) seizure frequency observation. Participants enrolled were 50 patients with new-onset general epilepsy (Mage = 7.2 ± 2.0; 54 % male; 46% female Indonesian). Patient/parent-self reported methods resulted mean overall adherence scores across patients during this 6-months period was 4.07 ± 1.15 (81.4%). Meanwhile phenytoin assay indicated only 18% patients reached therapeutics concentration. Seizure frequency observation revealed 81% improvement in seizure frequency (t= 7.63, P=0.000) after 6 months therapy. Negative correlations were found between Parents/patients-self reporting with drug levels(rho=-0.082, P=0.59); Parents/patients-self reporting with seizure frequency(rho=-0.17, P=0.24). Correlation between seizure frequency with phenytoin level was also proved by Spearman test as no significant (rho=0.12, P=0.42). 7 patients (14%) remain had seizure after 6 months but only 2 patients were having miss dose. There were lack of correlation between the various methods of adherence measurement but it does not necessarily reflect a minimum in adherence.

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