The Importance of Treatment Compliance

Compliance is particularly important in epilepsy treatment because of the risk of seizures if the level of medication in the blood falls too low.

Compliance is a term which describes the degree to which the person with epilepsy (or the parent of a child with epilepsy) follows the physician’s directions on how and when medicine should be taken, and (sometimes) on what kinds of lifestyle changes should be made.

Factors Related to Compliance:

  • MotivationDegree of illness threat
  • Expectation of effectiveness
  • AttitudesProvider/patient interaction
  • Social support
  • Experience with the regimen
  • Internal control
  • Knowledge

Patient Beliefs/Actions Related to Non-Compliance:

  • Do not need so much medication
  • Inconvenience of schedule
  • Unpleasant side effects
  • Denial of need
  • Making the drug last longer because of cost
  • Physical limitations
  • Forgetfulness
  • Run out of medication
  • Confusion about times, doses
  • Poor family support
  • Embarrassed to take medication in front of others
  • Inability to follow dosage instructions

Compliance with medication schedules is a challenge for people with many kinds of acute or chronic illness. Studies show at least 15 percent of all such patients are non-compliant, and some estimates put the figure as high as 50 percent. However, compliance is particularly important in epilepsy treatment because of the risk of seizures if the blood level falls too low. A recent study showed 73 percent of people with epilepsy to be compliant; others report more than 50 percent sometimes forget or fail to take their medication.

Pill reminder boxes or calendars can be effective to help a person remember to take medication. Watches with beeper alarms can serve the same function. Some physicians feel that measuring blood levels from time to time helps to encourage compliance, since a reduced level would suggest that not enough medication is being taken.

Patient education, including information about half lives and their importance in maintaining adequate drug levels, may help, together with simple dosing schedule (some reports show better compliance with fewer doses to remember), cues (pills placed near a toothbrush to facilitate the morning and evening dose), and patient follow up by the physician.