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. 2011 Feb;52(2):370-6.
doi: 10.1111/j.1528-1167.2010.02789.x. Epub 2010 Nov 18.

Development and reliability of a correction factor for parent-reported adherence to pediatric antiepileptic drug therapy

Avani C Modi  1 , Shanna M Guilfoyle, Diego A Morita, Tracy A Glauser
Affiliations

Development and reliability of a correction factor for parent-reported adherence to pediatric antiepileptic drug therapy

Avani C Modi et al. Epilepsia. 2011 Feb.

Abstract

Purpose: Study aims were (1) to document and examine associations between parent-report and electronic monitoring (EM) of pediatric antiepileptic drug (AED) adherence, (2) to determine the sensitivity and specificity of parent-reported adherence, and (3) to develop a correction factor for parent-reported adherence.

Methods: Participants included 111 consecutive children with new-onset epilepsy (M(age) = 7.2 ± 2.0; 61.3% male; 75.8% Caucasian) and their primary caregivers. AED adherence was electronically monitored for 3 months prior to the 4-month clinic follow-up visit. Parent-reported adherence captured adherence 1-week prior to the clinic visit. For specificity/sensitivity analyses of parent-reported adherence, cut points of 50%, 80%, and 90% were used with electronically monitored adherence calculated 1-week prior to the clinic visit as the reference criterion.

Key findings: Electronically monitored adherence (80.3%) was significantly lower than parent-reported adherence (96.5%; p < 0.0001) 1-week prior to the clinic visit, but both were significantly correlated (rho = 0.46, p < 0.001). The 90% parent-reported adherence cut point demonstrated the most sensitivity and specificity to electronically monitored adherence; however, specificity was still only 28%. A correction factor of 0.83 was identified as a reliable adjustment for parent-reported adherence when compared to electronically monitored adherence.

Significance: Although EM is the gold standard of adherence measurement for pediatric epilepsy, it is often not clinically feasible to integrate it into routine clinical care. Therefore, use of a correction factor for interpreting parent-reported adherence holds promise as a reliable clinical tool. With reliable adherence measurement, clinicians can provide adherence interventions with the hope of optimizing health outcomes for children with epilepsy.

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Conflict of interest statement

None of the authors has any conflict of interest to disclose.

Figures

Figure 1
Figure 1
Nonadherence Rates by 50%, 80%, 90% Adherence Cut-Points 1-Week Prior to Clinic Visit
See this image and copyright information in PMC

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