Factors linked to adhesion to treatment in patients with refractory and non-refractory epilepsy

Introduction. Non-compliance with therapy is a problem in clinical practice in chronic diseases. Nevertheless, there are important gaps in our knowledge on this subject and its associated factors in patients with epilepsy. Moreover, failure to comply could lead to poor classification of the patients according to the definition of refractory epilepsy. Aims. To examine the behaviour in terms of therapy compliance and the clinical, psychosocial and developmental factors involved in a group of patients with epilepsy, and also to analyse the differences in the psychosocial variables depending on the degree of resistance. Patients and methods. The study involved 112 epileptic patients recruited consecutively in the epilepsy unit of a tertiary health care centre. Patients were administered a questionnaire designed to collect sociodemographic and clinical variables, together with data about treatment, adhesion, reasons for non-compliance, social support, health, welfare and degree of response to treatment. Results. The levels of non-compliance with therapy agreed with those found in previous studies. No significant differences in the level of adhesion were found between patients with refractory epilepsy and pharmacologically-controlled epilepsy, although significant differences were observed in the level of health, welfare, social support and other associated variables. Conclusions. The level of compliance of epileptic patients is rather poor. Patients with refractory epilepsy are more aware of the severity of their disease, they are more critical with the health care system and with their social setting, and they tend to comply better with their treatment. Hence, there are no reasons to believe that therapy non-compliance can explain a high proportion of the resistance that exists in epilepsy.