Electronic Diary May Improve Adherence to AEDs in Women with Epilepsy Who Are Planning Pregnancy

A study published in the scientific journal, Epilepsia, shows that electronic diaries may help women with epilepsy who are planning a pregnancy adhere to treatment schedules.

The results of the study, conducted at New York University Langone Epilepsy Center, Mount Sinai School of Medicine and Brigham and Women’s Hospital, suggest that electronic diaries could be useful in clinical settings to enhance patient and medication management.

In a press release, the senior author of the study, Dr Jacqueline French, said: “Monitoring of medication adherence presents a tremendous challenge to clinicians and to clinical researchers. Poor adherence has been shown to negatively impact health care spending by resulting in more emergency room visits and hospitalizations, and may result in incomplete seizure control and increased risk of sudden death. Many times, patients do not report to their doctor about missed medication doses. This information could be used to discuss and improve compliance.”

Women with epilepsy who are pregnant are at particular risk of missing antiepileptic drug (AED) doses (e.g. due to sickness, or fear of harming their baby), but breakthrough seizures can be more harmful to both the mother and child (and so adherence to prescribed treatment is very important).

For the study, the researchers gave women with epilepsy who were planning to become pregnant an iPod Touch loaded with a customised mobile application called the WEPOD App that can track daily data.

A total of 86 women with epilepsy tracked their seizures and AED use and were included in the study. The researchers followed these women from the time of study enrolment throughout their pregnancy, and up to the birth of their child, or for women who did not become pregnant, for up to 12 months.

The results showed that 75% of women who used the electronic diary tracked their use of AEDs on a daily basis for more than 80% of the study period. These women were included in the data analysis and they showed a 97.7% adherence to medication. In addition, 44% of them admitted to missing an AED on at least one day.

Interestingly women who tracked their use of both AEDs and non-epilepsy medications reported a higher rate of adherence with AEDs than with other medications, suggesting that perceived importance of medications may influence adherence.

According to the authors the high rate of adherence may, in part, be a result of  some of the electronic diary’s properties, such as daily reminders and real time feedback given to the provider.

Further research is needed to confirm these findings, and also to investigate how electronic diaries might help other groups of people with epilepsy (who aren’t women planning a pregnancy) adhere to their AED regimens.

Author: Dr Özge Özkaya

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