Factors and issues on treatment adherence among Filipino patients with epilepsy and their caregivers

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Non-adherence to treatment in epilepsy is considered as a worldwide problem ranging from 30-50% of patients. Despite its striking magnitude, only a few studies tried to explain the factors affecting it. Moreover, a standard method to measure adherence to treatment among patients is still lacking. An in-depth analysis on adherence to treatment of patients with epilepsy, taking into factor their values, beliefs, and culture, is deemed necessary.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> The purpose of this qualitative study is to investigate the contributory factors and issues on treatment adherence faced by Filipino patients with epilepsy and their caregivers. This study also aimed to serve as a catalyst to further stimulate local researches on treatment adherence in epilepsy.</p><p style="text-align: justify;"><strong>METHODS:?</strong>Four focus group discussions were conducted with patients and caregivers who voluntarily agreed to participate and share their experiences on dealing with epilepsy. A total of 39 participants were included. The focus group discussions, facilitated by skilled moderators, were composed of an ice breaker and a discussion on the experiences and issues faced by the participants. The discussions were transcribed and analyzed using thematic coding.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Three main content categories were identified from the focus group discussions, namely, 1) accepting a life with epilepsy, 2) dealing with the disease, and 3) ensuring freedom from seizure attacks, which were further sub-categorized. From these, a number of factors affecting treatment adherence were identified and a conceptual framework was developed by the investigators.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study was able to demonstrate that conducting a focus group discussion was an effective means of eliciting the experiences and issues in patients and their caregivers. Several factors affecting treatment adherence such as patient-doctor relationship, financial resources, government support, adverse medication effects, religious belief, trigger avoidance, frequent reminders, and safety precautions were elucidated in this study.</p>

Delivery, breast feeding and child rearing in women with epilepsy

The occurrence of seizures during delivery is very low and convulsive status epilepticus is rare. Seizure freedom for at least 9 months prior to pregnancy is associated with a high likelihood of remaining seizure-free during pregnancy. Mode of delivery during pregnancy is most often based on obstetrical indications. Recent evidence shows good maternal and fetal outcome for pregnancy in women with epilepsy. Breastfeeding is encouraged for most mothers with epilepsy and is generally safe. There is a large knowledge gap on studies looking into the child rearing knowledge and practice of mothers with epilepsy.