뇌전증을 가진 소아청소년의 복용 순응도에 영향을 미치는 요인
Clinical Factors influencing Antiepileptic Drug Compliance of Children and Adolescents with Epilepsy
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목적: 뇌전증의 발작 조절에 항경련제에 대한 순응도가 중요하다. 소아청소년 뇌전증 환자의 항경련제에 대한 복용 순응도와 이에 영향을 주는 임상 인자에 대해 알아보고자 하였다. 방법: 2015년 2월 1일부터 2월 28일 동안 고려대학교 안산 및 안암병원 소아신경 클리닉을 방문한 소아청소년 뇌전증 환자들을 대상으로 최근 1개월, 6개월의 약물 복용에 대해 파악하고, 약물 순응도와임상인자와의 연관을 분석하였다. 결과: 총 191명의 대상 환자 중 129명(67.5%)이 최근 1개월 동안 항경련제를 빠짐없이 복용하였다. 정기적으로 환자가 직접 병원에 방문하여 진료 받은 횟수가 순응도와 관련되었고(adjusted odds ratio [AOR]: 5.78, P=0.000), 항경련제 단일요법 복용 환자들이 복합요법에비해 순응도가 좋았다(AOR: 3.14, P=0.006). 복약 누락 횟수가 많을수록 발작 빈도가 높았다(r=0.374, P=0.000). 결론: 소아청소년 연령에서 환자가 직접 방문하지 않고 보호자가대신 진료를 받는 환자들과 항경련제 복합요법을 시행하는 환자들에대한 보다 면밀한 약물 순응도 파악과 관리가 필요하다.
Abstract
Purpose: Medication compliance is crucial for optimizing seizure control. The aim of this study was to evaluate the relationship between antiepileptic drug (AED) compliance and clinical factors in pediatric population. Methods: We interviewed all epileptic patients who visited the epilepsy clinic at Korea University Ansan and Anam Hospitals during a period of one month and reviewed their medical charts. Drug compliance was evaluated in terms of the number of missed AEDs during the recent 1 and 6 month in this study and the relationship between drug compliance and clinical factors was analyzed. Results: The study included 191 patients. Of these, 129 (67.5%) patients reported taking each AED regularly, without missing a dose for recent 1 month. A history of patient’s regular clinic visits was associated with good compliance (adjusted odds ratio [AOR]: 5.78, P=0.000). And, patients who received AED monotherapy had better compliance than those who received AED polytherapy (AOR: 3.14, P=0.006). Spearman correlation was detected for seizure frequency and the number of missed doses (r=0.374, P=0.000). Conclusion: More careful monitoring the patients who skipped their clinic visits and prescribing the possible minimum number of AEDs would be helpful to increase the drug compliance in children and adolescents with epilepsy.
참고문헌 (28)
- Fisher RS, "Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)", Epilepsia, 46, pp.470~472 (2005)
- Wallace H, "Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy", Lancet, 352, pp.1970~1973 (1998)
- McDonnell PJ, "Hospital admissions resulting from preventable adverse drug reactions", Ann Pharmacother, 36, pp.1331~1336 (2002)
- Schiff GD, "Decompensated heart failure: symptoms, patterns of onset, and contributing factors", Am J Med, 114, pp.625~630 (2003)
- Senst BL, "Practical approach to determining costs and frequency of adverse drug events in a health care network", Am J Health Syst Pharm, 58, pp.1126~1132 (2001)
- Misdrahi D, "Compliance in schizophrenia: predictive factors, therapeutical considerations and research implications", Encephale, 28, pp.266~272 (2002)
- Rodgers PT, "Medication nonadherence: Part II--A pilot study in patients with congestive heart failure", Manag Care Interface, 11, pp.67~69 (1998)
- Eadie MJ, "Plasma level monitoring of anticonvulsants", Clin Pharmacokinet, 1, pp.52~66 (1976)
- Bartels H., "Rational usage of therapeutic drug monitoring in antiepileptic treatmen", European journal of pediatrics, 133, pp.193~199 (1980)
- McNamara JO, "Drugs effective in the therapy of the epilepsies" (2001), McGraw-Hill
- Asadi-Pooya AA., "Drug compliance of children and adolescents with epilepsy", Seizure, 14, pp.393~395 (2005)
- "Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy", Epilepsia, 30, pp.389~399 (1989)
- "Oxford advanced learner’s dictionary of current English. 7", pp.296~ (2005), Oxford University Press
- Eatock J, "Managing patient adherence and quality of life in epilepsy", Neuropsychiatr Dis Treat, 3, pp.117~131 (2007)
- Jones RM, "Adherence to treatment in patients with epilepsy: associations with seizure control and illness beliefs", Seizure, 15, pp.504~508 (2006)
- Osterberg L, "Adherence to medication", N Engl J Med, 353, pp.487~497 (2005)
- Hovinga CA, "Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: survey of patients with epilepsy and physicians", Epilepsy Behav, 13, pp.316~322 (2008)
- Navarro V, "Improving medication compliance in patients with depression: Use of orodispersible tablets", Adv Ther, 27, pp.785~795 (2010)
- 유선영, "소아청소년기 후두 신경통 환자에서 후두 신경 차단의 효과", 대한소아신경학회지, 22(2), pp.77~81 (2014), 대한소아신경학회
- Cramer J, "Dose frequency and dose interval compliance with multiple antiepileptic medications during a controlled clinical trial", Epilepsia, 36, pp.1111~1117 (1995)
- Hulka BS, "Communication, compliance, and concordance between physicians and patients with prescribed medications", American journal of public health, 66, pp.847~853 (1976)
- Ferrari CMM, "Factors associated with treatment non-adherence in patients with epilepsy in Brazil", Seizure, 22, pp.384~389 (2013)
- Kyngäs H., "Compliance of adolescents with chronic disease", Journal of clinical nursing, 9, pp.549~556 (2000)
- Choi YH, "Compliance with Anticonvulsant Therapy in Epileptic Children", Korean Journal of Pediatrics, 41, pp.1553~1558 (1998)
- Chandra R, "Compliance monitoring in epileptic patients", The Journal of the Association of Physicians of India, 41, pp.431~432 (1993)
- Kwon O, "Factors Influencing Compliance in Epileptic Patients", Journal of the Korean Neurological Association, 12, pp.215~224 (1994)
- Brown I, "Enhancing antiepileptic drug adherence: a randomized controlled trial", Epilepsy & Behavior, 16, pp.634~639 (2009)
- Barker-Haliski M, "What are the arguments for and against rational therapy for epilepsy?", Adv Exp Med Biol, 813, pp.295~308 (2014)