One of the major barriers to the control of chronic illness occurs when patients do not take their medications as instructed. Nonadherence to epilepsy medications, for example, can interfere with treatment and may adversely affect clinical outcomes, although few studies have examined this relationship. Hovinga and coworkers assessed barriers and drivers to adherence, the impact of compliance on quality of life, and the importance of the patient-physician relationship to adherence. Two cross-sectional online surveys were conducted among 408 adult patients with epilepsy and 175 neurologists who treat epilepsy patients. Twenty-nine percent of patients reported not being adherent to antiepileptic medications in the prior month. Nonadherence was found to be associated with reduced seizure control, lowered quality of life, decreased productivity, seizure-related job loss, and seizure-related motor vehicle accidents.

WHAT THE STUDY MAY MEAN TO YOU: The authors concluded that patient-oriented epilepsy treatment programs and clear communication strategies to promote self-management and patients' understanding of epilepsy are essential to maximizing treatment and quality of life outcomes while also minimizing economic costs. We concur with this conclusion: components for teaching patients to manage their chronic illness must be built into all self-management programs for all chronic conditions.

CA Hovinga et al. Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: Survey of patients with epilepsy and physicians. Epilepsy & Behavior, May 8, 2008.