Epilepsy & Behavior最新文献

{"title":"Preparing adolescents and young adults with epilepsy for transitioning health care (PATH) study: The important role of age and self-efficacy","authors":"Amy C. Lang ,&nbsp;Kirby-Estar Laguerre ,&nbsp;Stacy Buschhaus ,&nbsp;Constance A. Mara ,&nbsp;Susan L. Fong ,&nbsp;Christina L. Duncan ,&nbsp;Avani C. Modi","doi":"10.1016/j.yebeh.2024.110167","DOIUrl":"10.1016/j.yebeh.2024.110167","url":null,"abstract":"<div><h3>Background</h3><div>At least 30% of youth with epilepsy will require transition from pediatric to adult neurology care. Many adolescents and young adults (AYAs) with epilepsy are inadequately prepared for health care transition, which may contribute to health care disruptions and decreased quality of life. The current study aimed to add to the growing body of literature on health care transition in epilepsy by characterizing a sample of AYAs with epilepsy and assessing the relationship between pre-existing and behaviorally modifiable factors and epilepsy-specific transition readiness.</div></div><div><h3>Methods</h3><div>103 AYAs (<em>M_age</em> = 17.56; range = 14–21; 54% female; 85% White) with epilepsy and 84 of their caregivers were enrolled from two pediatric hospitals in the United States. Participants provided sociodemographic and medical information and completed questionnaires assessing functioning, epilepsy management, and transition readiness. Data were analyzed using a two-step hierarchical multiple linear regression model with epilepsy-specific transition readiness as the outcome: 1) pre-existing factors (i.e., age, insurance, seizure severity); and 2) behaviorally modifiable factors (i.e., cognitive functioning, medication self-management, epilepsy self-efficacy).</div></div><div><h3>Results</h3><div>Only 44% of AYAs had discussed health care transition with their pediatric neurologist. The final model was significant, Δ<em>F</em> (3, 90) = 13.45<em>, p</em> &lt; 0.001. Older age and greater epilepsy self-efficacy were associated with greater epilepsy-specific transition readiness.</div></div><div><h3>Conclusion</h3><div>AYAs with greater epilepsy self-efficacy may be better prepared for the transition from pediatric to adult neurology care. Routine assessment of epilepsy self-efficacy and transition readiness starting in early adolescence may help to identify individuals who could benefit from targeted interventions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110167"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of EEG after a first unprovoked seizure in adults – A population-based study","authors":"Sara Joelsson ,&nbsp;Klara Andersson ,&nbsp;Petra Brannefors ,&nbsp;Samuel Klemetz ,&nbsp;Lovisa Gärdesmed ,&nbsp;Elisabet Wennberg ,&nbsp;Anders Hedström ,&nbsp;Fredrik Asztely ,&nbsp;Johan Zelano ,&nbsp;Joakim Strandberg","doi":"10.1016/j.yebeh.2024.110151","DOIUrl":"10.1016/j.yebeh.2024.110151","url":null,"abstract":"<div><h3>Objective</h3><div>Electroencephalography (EEG) is a standard investigation after a first unprovoked seizure but the diagnostic value in adults remains unclear. Our objective was to investigate the diagnostic value of EEG after a first unprovoked seizure in a population-based cohort in Gothenburg, Sweden.</div></div><div><h3>Methods</h3><div>This retrospective population-based study included adult patients referred by a neurologist for EEG after a first unprovoked seizure from August 2016 - December 2019 in the greater Gothenburg catchment area. In total 520 patients were included and followed in medical records for a median of 4.42 years (range 0.33–6.93). Primary outcome measures were epileptiform activity. Medical records were reviewed for the influence of EEG on clinical management. The frequency of epileptiform activity was calculated and compared in different subgroup analyses.</div></div><div><h3>Results</h3><div>EEGs were recorded after a median of 70 days from the seizure. In total, 7.7 % had epileptiform activity, and 27.9 % had pathological slowing on their EEG. Seizure recurrence occurred in 33.7 % (29.6–37.8). Epileptiform activity predicted seizure recurrence with a recurrence risk of 82.5 % (70.7–94.3). The sensitivity of epileptiform activity was only 19.2 % (13.6–25.9) but the specificity was 98.0 % (95.9–99.2) and the relative risk of recurrence in presence of such activity was 2.8 (2.3–3.5). The EEG findings resulted in an alteration of diagnosis and/or medication in 4.4 % of the patients. Factors associated with epileptiform activity on EEG were younger age, EEG including sleep recording, generalized onset seizure, shorter time from seizure to EEG and longer duration of EEG recording.</div></div><div><h3>Significance</h3><div>The yield of EEG recorded with a longer latency after a first unprovoked seizure in adults was low. However, epileptiform activity highly predicted seizure recurrence and our results suggest that epileptiform activity on EEG could be explored further as a biomarker for defining epilepsy already after a first seizure.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110151"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting knowledge, attitudes and perceptions towards epilepsy after a decade of interventions: The case of Tbilisi, Georgia","authors":"Sofia Kasradze ,&nbsp;Giorgi Lomidze ,&nbsp;Nino Gogatishvili ,&nbsp;Salome Mgeliashvili ,&nbsp;Tamara Antia ,&nbsp;Josemir W Sander","doi":"10.1016/j.yebeh.2024.110166","DOIUrl":"10.1016/j.yebeh.2024.110166","url":null,"abstract":"<div><h3>Objective</h3><div>One of the most significant challenges faced by people with epilepsy is the stigma imposed by the broader community. We aim to assess the dynamics of stigma and the level of misconceptions towards individuals with epilepsy by comparing two studies conducted decades apart.</div></div><div><h3>Methods</h3><div>Awareness-raising campaigns and professional skill development activities were conducted. We utilised a Georgian-adapted structured questionnaire and the Stigma Scale of Epilepsy (SSE) questionnaire, which had previously been validated in Georgian. A cross-sectional study was conducted. We used multivariable logistic regression analysis to develop a predictive model for stigma perception. To compare the two studies, we used the Chi-squared test to examine differences in proportions between the two populations, including the 95% Confidence Interval (CI) for the difference in proportions. A p-value of less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of the 1,146 participants, 502 (43.8%) were female, and 207 (18.1%) had a medical education. Higher levels of stigma were observed more frequently among individuals without a medical background. Participants who perceived epilepsy as a psychiatric disorder, a hereditary condition, or a congenital disability exhibited higher levels of stigma. Comparisons between the two studies reveal a significant decrease in the number of individuals who would oppose their child marrying or playing with someone who has epilepsy.</div></div><div><h3>Conclusions</h3><div>Respondents with medical backgrounds were less likely to express stigma and misconceptions. A comparison of the two studies indicates a statistically significant improvement over the past decade, likely to be partly attributable to regular awareness-raising campaigns.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110166"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fellowship education in epilepsy in Latin America and Africa: Results of a survey","authors":"J.G. Burneo ,&nbsp;D.A. Steven ,&nbsp;D. Englot ,&nbsp;J.E. Bender del Busto ,&nbsp;K. Lin ,&nbsp;S. Wiebe ,&nbsp;J.M. Wilmshurst ,&nbsp;A. Cukiert ,&nbsp;F. Cendes ,&nbsp;for the Epilepsy Surgery in low resource settings Task Force","doi":"10.1016/j.yebeh.2024.110161","DOIUrl":"10.1016/j.yebeh.2024.110161","url":null,"abstract":"<div><div>A large proportion of those affected by epilepsy live in resource-poor areas. The Epilepsy surgery in low-resource settings Task Force from the ILAE undertook a survey in Africa and Latin America to identify fellowships in Epilepsy and EEG as well as in Epilepsy Surgery. The results revealed a significant shortage of training programs in these two regions of the globe.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110161"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatalism, self-management and self-esteem: How do they shape the quality of life in MS and epilepsy Patients?","authors":"Esin Kavuran","doi":"10.1016/j.yebeh.2024.110148","DOIUrl":"10.1016/j.yebeh.2024.110148","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of fatalism, self-management, and self-esteem on the quality of life of individuals with multiple sclerosis and epilepsy.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted between February and May 2024 with 122 MS patients and 108 epilepsy patients. Participants completed questionnaires measuring fatalistic beliefs, self-management, self-esteem, and quality of life. Data were collected through face-to-face interviews during hospital visits. Statistical analyses included t-tests, Mann-Whitney U tests, and hierarchical regression.</div></div><div><h3>Results</h3><div>MS patients reported significantly higher levels of fatalism and lower levels of self-esteem compared to epilepsy patients. However, both groups reported statistically significant relationships between fatalism, self-management, self-esteem, and quality of life. Hierarchical regression analyses revealed that the factor of fatalism negatively impacted quality of life in both groups, while self-management and self-esteem were positively associated with quality of life. Although these variables consistently impacted the quality of life for both groups, the magnitude of these effects and the amount of variance explained differed.</div></div><div><h3>Conclusions</h3><div>These findings highlight the importance of addressing fatalistic beliefs, promoting self-management skills, and enhancing self-esteem in both MS and epilepsy patients. Intervention programs focusing on these psychosocial factors could significantly improve the quality of life for individuals living with these chronic neurological conditions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110148"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of evolving treatment strategies for Dravet syndrome: Insights from randomized trials, meta-analyses, real-world evidence, and emerging therapeutic approaches","authors":"Debopam Samanta","doi":"10.1016/j.yebeh.2024.110171","DOIUrl":"10.1016/j.yebeh.2024.110171","url":null,"abstract":"<div><div>Dravet syndrome (DS) is a severe genetic developmental and epileptic encephalopathy, primarily caused by SCN1A gene mutations. Historically, treatments like clobazam and valproate have been used without evidence from randomized controlled trials (RCTs). However, the therapeutic landscape of DS has evolved with multiple RCTs demonstrating the efficacy and safety of three antiseizure medications (ASMs): stiripentol, cannabidiol (CBD), and fenfluramine. In the absence of direct comparisons between these therapies, several network <em>meta</em>-analyses have been conducted to compare the ASMs, while expert consensus has independently been developed to formulate treatment guidelines. While these three ASMs show promise in reducing seizures, increasing awareness of non-seizure outcomes—such as cognitive development and quality of life—has shifted the focus of evaluation. Some recent real-world studies of these ASMs have reported improvements in these non-seizure outcomes, alongside sustained efficacy and safety. However, natural history studies continue to underscore persistent deficits in these areas and highlight suboptimal long-term seizure control despite the use of these therapies. This review addresses these gaps by first discussing network <em>meta</em>-analyses and treatment guidelines, along with the practical limitations of these approaches. It then examines the long-term efficacy, safety, non-seizure effects, and cost-effectiveness from real-world studies of these ASMs. Finally, emerging research on novel therapeutic approaches, including genetic and serotonergic modulation, is explored. By evaluating these developments, this review aims to guide clinical decision-making and propose future directions for optimizing DS care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110171"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical exercise habits in people with epilepsy: A survey from Brazilian population","authors":"Ricardo Mario Arida ,&nbsp;Amanda Cristina Mosini ,&nbsp;Sarah Collard ,&nbsp;Maria Alice Susemihl ,&nbsp;Heitor Franco Santos ,&nbsp;Lavínia Teixeira-Machado","doi":"10.1016/j.yebeh.2024.110164","DOIUrl":"10.1016/j.yebeh.2024.110164","url":null,"abstract":"<div><div>This survey evaluated the Brazilian population’s physical exercise habits and compared them with those from two decades ago. In this cross-sectional study, 432 people with epilepsy (PWE) assessed the questionnaire. Of these, 387 (age: 33 ± 10.58, 81.4 % women) completed the questionnaire. Among them, 60.5 % were involved in regular physical activities. Among those who exercise regularly, the majority (96.5 %) exercised between 2 and 5 times weekly and had been physically active for at least two years. Only 23.3 % were prohibited by their doctors from participating in physical activities. Only 10 % reported that seizures occur during exercise, and about half of them (55.8 %) believed that exercise improves or has no effect on seizure frequency. Most (79.06 %) did not or rarely believe exercise can trigger seizures. More than half (57.3 %) were not afraid to have seizures during exercise or were not afraid of injury during exercise due to a seizure (69 %). Most believed exercise improves cognition (80.9 %), depression, and anxiety (93.8 %). We visited this scenario two decades early. In our previous study, only 15 % exercised regularly, while in this survey, 58.4 % routinely exercised. Our findings also align with our initial survey, indicating a low seizure frequency during regular exercise, a belief that physical activity reduces seizure frequency, and a reduction in the fear that exercise might trigger seizures. In conclusion, our results show that after two decades, there have been several improvements in physical and sports activity participation among PWE. Implementing strategies to reduce barriers to exercise for PWE and educating them on the benefits of physical activity can help improve this scenario.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110164"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of interaction among antiseizure medication polytherapy, clinical, sociodemographic and psychological factors on quality of life in patients with epilepsy: A systematic review","authors":"Alejandro Lozano-García ,&nbsp;Esperanza González-Bono ,&nbsp;Irene Cano-López","doi":"10.1016/j.yebeh.2024.110170","DOIUrl":"10.1016/j.yebeh.2024.110170","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug-resistant epilepsy usually requires the use of polytherapy with antiseizure medications (ASMs) for management, which could involve side and adverse effects that may impact quality of life (QOL). This systematic review summarizes the evidence about the relationship between ASM polytherapy and QOL in epilepsy patients, considering clinical, sociodemographic, and psychological variables.</div></div><div><h3>Method</h3><div>This review followed the PRISMA guidelines and was registered in PROSPERO. The studies examined were collected from PubMed/MEDLINE, Scopus, Web of Science, and Embase. The data extracted were categorized into three categories: the<!--> <!-->relationship between the number of ASMs and QOL, differences in QOL between patients taking polytherapy and patients taking monotherapy, and the<!--> <!-->role of other variables on QOL.</div></div><div><h3>Results</h3><div>The review included 34 studies. Thirty examined the relationship between the number of ASMs and QOL, 93.3% of them identifying a significant association between a higher number of ASMs and poorer QOL. Fifteen studies analyzed differences in QOL between patients receiving polytherapy and those on monotherapy, all of them showing poorer QOL in those on polytherapy. Thirty-two studies considered other factors beyond polytherapy as determinants of QOL, including clinical, sociodemographic, and psychological variables, and higher seizure frequency and mood comorbidities (depression and anxiety) emerged as the strongest predictors of poor QOL.</div></div><div><h3>Conclusions</h3><div>Polytherapy, despite being necessary for managing drug-resistant epilepsy, significantly contributes to impairing QOL. Effective seizure control remains critical, but a multifactorial approach addressing mental health and social determinants is essential for improving QOL in epilepsy patients. Future research should focus on optimizing treatment strategies that balance seizure control by minimizing the negative impact of polytherapy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110170"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central expression and peripheral levels of MMP-9 and TIMP-1 in patients with temporal lobe epilepsy","authors":"Andrea Toledo ,&nbsp;Sandra Orozco-Suarez ,&nbsp;Yamile Paredes Chiquini ,&nbsp;Daniel Sanchez ,&nbsp;Lorenzo Maldonado ,&nbsp;Jorge Flores ,&nbsp;Sara I. Bautista ,&nbsp;Alfonso Arellano ,&nbsp;Sergio Moreno ,&nbsp;Iris E. Martínez Juárez ,&nbsp;Agnès Fleury","doi":"10.1016/j.yebeh.2024.110163","DOIUrl":"10.1016/j.yebeh.2024.110163","url":null,"abstract":"<div><h3>Purpose</h3><div>Thirty percent of epilepsy patients are drug-resistant (DR) and, in adults, temporal lobe epilepsy (TLE) is the most common form of DR- epilepsy. Patients with TLE exhibit a neuroinflammatory response associated with blood–brain barrier dysfunction. In this context, the main aim of our study was to evaluate peripheral levels and central expression of MMP-9 and TIMP-1 in TLE patients and assess their association with drug resistance and inflammatory markers.</div></div><div><h3>Methods</h3><div>Three groups of patients were included, 41 DR-TLE patients, 10 non-DR-TLE patients, and 20 healthy controls (HC). MMP-9 and TIMP-1 were assessed by ELISA in sera in all patients, and by immunohistochemistry and immunofluorescence in the cerebral cortex and hippocampus in a subgroup of DR-TLE patients and 3 controls. Peripheral and central cells phenotypes were determined by flow cytometry and immunohistochemistry, respectively, while cytokines were determined in the two compartments by ELISA.</div></div><div><h3>Results</h3><div>Central expression of MMP-9 and TIMP-1, and peripheral expression of TIMP-1, were higher in DR-TLE patients than in controls, while peripheral levels of MMP-9 and TIMP-1 were higher in DR-TLE patients compared with non-DRE-TLE patients. MMP-9 levels in serum increased with seizure severity and decreased after successful epilepsy surgery. MMP-9 levels in the serum of DR-TLE patients were positively correlated with several markers of peripheral inflammation, which was not the case in the groups of non-DR-TLE patients and healthy controls. MMP-9 and TIMP-1 expression in the hippocampus of DR-TLE patients correlated positively with various markers of central inflammation. Negative correlations between their peripheral levels and central expression were observed.</div></div><div><h3>Conclusion</h3><div>MMP-9 and TIMP-1 are markers that seem to be associated to the central and peripheral inflammatory reaction occurring in DR-TLE patients. The significant negative correlations between central and peripheral markers are interesting to note, and further studies need to be carried out to fully understand the complex regulation of these proteins during DR epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110163"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting medication adherence among children with epilepsy: Application of the protection motivation theory","authors":"Chunsong Yang ,&nbsp;Weiqi Deng ,&nbsp;Linan Zeng ,&nbsp;Qiuji Tao ,&nbsp;Lingli Zhang","doi":"10.1016/j.yebeh.2024.110153","DOIUrl":"10.1016/j.yebeh.2024.110153","url":null,"abstract":"<div><h3>Purpose</h3><div>Based on the protection motivation theory (PMT), which is an extension of the health belief model that takes the “reward” brought by behavior in the long-term process as a consideration factor and considering the influence of environmental and social factors on behavior patterns, this cross-sectional study evaluated medication adherence among children with epilepsy using structural equation modeling.</div></div><div><h3>Methods</h3><div>Children with epilepsy from pediatric neurology clinics were consecutively sampled at West China Second Hospital of Sichuan University from July 2021 to January 2024. According to PMT, we designed the 23-item questionnaire, which included seven factors, namely severity, susceptibility, external return, internal returns, self-efficacy, reaction efficiency, and reaction cost. Medication adherence was assessed using the Morisky Medication Adherence Scale. The reliability and validity of the scale were tested by confirmatory factor analysis, and path analysis was used to conduct hypothesis testing and calculate standardized path coefficients.</div></div><div><h3>Results</h3><div>We enrolled 1357 children with epilepsy (mean age, 8.36 ± 4.04 years). Younger age, being an only child, caregivers’ unemployment, and comorbidities were associated with high medication adherence scores. The designed scale of PMT displayed good reliability and validity. Through path analysis of the structural equation model, self-efficacy, susceptibility, and severity exerted significant positive effects on adherence, and external return, internal returns, and reaction cost had significant negative effects on adherence.</div></div><div><h3>Conclusions</h3><div>Medication adherence in children with epilepsy is relatively poor. PMT can explain and predict the medication adherence behavior and behavior intention of patients with epilepsy. It is recommended to increase the health education, personalize medication guidance, and provide telephone interventions to caregivers of children with epilepsy to enhance medication adherence and further improve therapeutic efficacy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110153"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}