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Objectives: The objectives of this study were to evaluate the effects of medication education and behavioral intervention on Chinese patients with epilepsy and to compare the difference between them., Methods: A total of 109 patients with epilepsy who did not to take their antiepileptic drugs (AEDs) more than once were randomly assigned to two intervention groups: the medication education group (group I) and the medication education with behavioral intervention group (group II). Group I was initially provided with medication education in the form of oral education and written materials, and this education was reinforced by monthly calls from the pharmacist over the next six months. The behavioral intervention provided to group II consisted of a modified medication schedule which was based on cue-dose training therapy. The outcomes that were evaluated both in the beginning and in the end of the study included adherence, which was measured using the four-item Morisky Medication Adherence Scale (MMAS-4), the number of seizures, knowledge of AEDs, and the number of patients who missed a dose of their AEDs. Differences within and between the groups were analyzed., Results: After intervention, the adherence and knowledge of AEDs increased greatly in all patients, and the number of patients who had seizures or missed AEDs decreased. However, no significant differences were observed between groups I and II. The observed changes were (group I vs group II, p value) increased adherence: 62.3% vs 64.3%, 0.827; increased knowledge of AEDs: 88.7% vs 80.4%, 0.231; and improved seizure control: 64.2% vs 64.3%, 0.988. In addition, the percentage of patients who forgot to take their AEDs decreased to 45.0% from more than 70%, and 44.9% of these patients took the missed AEDs as soon as they remembered., Discussion: These findings clearly demonstrate that medication education and reinforced telephone calls from pharmacists can help to increase adherence to AEDs, the knowledge of patients regarding AEDs, and seizure control. However, the inclusion of a behavioral strategy that was easy to administer and use in this program did not lead to any significant effects on improving adherence. The results indicate that pharmacists can play an important role in improving the effects of medication regimens, but further research is required to identify strategies for improving adherence to behavioral theory., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Abstract: Objectives: The objectives of this study were: (1) to evaluate self-reported adherence in adult patients with epilepsy in China who had missed taking their antiepileptic drugs (AEDs) at least once and (2) to determine why patients were not adherent to their medication to employ interventions targeted at barriers to adherence. Methods: A questionnaire was used to collect the patients'' demographic data, disease information, and reasons for why the patients did not take their AEDs. Adherence was also included as measured using a four-item Morisky questionnaire (Morisky-4 questionnaire). Results: Of the 131 patients, 4.6%, 70.2%, and 25.2% showed high, medium, and low adherence, respectively. The reasons for nonadherence included forgetfulness (54.2%), being seizure-free for a period (48.9%), and fear of adverse drug effects (27.5%). Conclusions: Medium adherence was the predominant nonadherence pattern, and forgetfulness, being seizure-free for a period, and fear of adverse effects were the primary reasons for nonadherence to AEDs. To overcome barriers to nonadherence, it is essential to use tools that are sensitive to reasons for nonadherence. [Copyright &y& Elsevier]