Treatment Adherence Needed in Epilepsy Patients

People with active epilepsy have been shown to be more likely to report poor health, be unemployed, and live in households with the lowest annual incomes.

The CDC recently completed a multi-state study that “examined the prevalence of epilepsy or seizure disorder in 19 states” using the data of 120,000 adults age 18 years and older from the 2005 Behavioral Risk Factor Surveillance System. Based on the results published in MMWR, the CDC investigators learned that people with active epilepsy are more likely to:

• Report fair or poor health

• Be unemployed or unable to work

• Live in households with the lowest annual incomes

• Have a history of comorbid disorders

• Have low health-related quality of life

• Be obese, physically inactive, and smokers

Other key findings include:

• 16.1% reported not taking their epilepsy medication

• 65.1% reported having had more than one seizure in the past month

• 23.7% reported financial difficulties as a reason for not seeing a doctor within the past year

• 34.9% reported not having seen a neurologist or epilepsy specialist in the previous year

• 1.65% of adults were not told by a doctor that they had epilepsy or a seizure disorder

• About 1 out of 100 adults have active epilepsy

“Despite having recent seizures, more than one out of three adults reported not seeing a neurologist or epilepsy specialist in the past year,” said co-author David Thurman, neurologist, CDC Division of Adult and Community Health. “These findings suggest that adults with uncontrolled seizures may not be receiving the optimal medical treatment they need and may face substantial impairments in their daily activities.”

These discouraging results emphasize the importance of the physician—patient relationship in promoting treatment adherence and the need for physicians to provide easy-to-read educational materials to their patients. It may be obvious, but physicians really do play a vital role in making patients understand how important it is to properly take their AEDs and to see a neurologist at least once a year. It’s also key for physicians to reinforce the message to patients that although they have epilepsy that may lead to loss of driving privileges, they can still lead a normal, healthy life.

“While epilepsy is one of the most common neurological conditions, most people know very little about this disorder, or how to support those with epilepsy,” said Janet Collins, PhD, director of the CDC National Center for Chronic Disease Prevention and Health Promotion. “We hope this report, which provides the largest and most comprehensive data on epilepsy in the United States, can help states and public health agencies better understand the prevalence of epilepsy, as well as epilepsy-associated conditions and limitations.”

Are you surprised by the data presented in the CDC report? What can physicians do to help improve the situation?