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BMC Complementary Medicine and Therapies

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Open Access 01-12-2021 | Antiepileptic Drugs | Research article

Impact of complementary and alternative medicines on antiepileptic medication adherence among epilepsy patients

Authors: Muhammad Junaid Farrukh, Mohd Makmor-Bakry, Ernieda Hatah, Tan Hui Jan

Published in: BMC Complementary Medicine and Therapies | Issue 1/2021

Abstract

Background

The aim of this study was to assess the knowledge, attitude, and practice of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy.

Methods

A cross-sectional study was carried out on 100 epilepsy patients, aged 18 years or older that did not have any physical or psychiatric illness. A patient-administered questionnaire was used to assess their knowledge, attitude towards, practice, and perceived effectiveness (KAPP) of CAM. Established adherence assessment tools were used to determine patient medication adherence.

Results

The prevalence of CAM usage was found to be at 58%. CAM was used more frequently by males (n = 32, 60.4%) than by females (n = 26, 55.3%; p = 0.609). The most commonly used CAM included vitamins and minerals (36%), ginseng (16%), antioxidants (15%), and acupuncture (12%). A significant number of patients had low knowledge of (59%) and a positive attitude (54%) toward complementary and alternative medicine. Main reasons for using CAM were a lower price, better availability, and inadequate seizure control by AEDs. About 43% of the patients who used CAM informed their doctor. Prevalence of non-adherence to AED therapy was found to be 68%. A significant association was found between non-adherence and CAM usage (p < 0.01).

Conclusion

A high prevalence of CAM usage and non-adherence to AEDs among epilepsy patients was identified. CAM usage was associated with a non-adherence to AED therapy. This study highlights the need to explore CAM usage with patients before making clinical decisions to achieve the best outcomes from AED therapy.

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WHO. Epilepsy fact sheet. Geneva: WHO; 2016. http://www.who.int/mediacentre/factsheets/fs999/en/. Accessed Jul 10 2019

Marks WJ, Garcia PA. Management of seizures and epilepsy. Am Fam Phys. 1998;57(7):1589 600, 1603, 603–4 [Pubmed:9556647].

Farrukh MJ, Makmor-Bakry M, Hatah E, Tan HJ. Use of complementary and alternative medicine and adherence to antiepileptic drug ther apy among epilepsy patients: a systematic review. Patient Prefer Adherence. 2018;12:2111–21. https://doi.org/10.2147/PPA.S179031 Pubmed:30349205.CrossRefPubMedPubMedCentral

Rhodes PJ, Small N, Ismail H, Wright JP. The use of biomedicine, complementary and alternative medicine, and ethnomedicine for the treatment of epilepsy among people of south Asian origin in the UK. BMC Complement Altern Med. 2008;8(1):7. https://doi.org/10.1186/1472-6882-8-7 Pubmed:18366698.CrossRefPubMedPubMedCentral

Jasamai M, Islahudin F, Samsuddin NF. Attitudes towards complementary alternative medicine among Malaysian adults. J Appl Pharm Sci. 2017;7(06):190–3.

Chu MM. Traditional medicine lacks stringent regulations. Star Online. https://www.thestar.com.my/news/nation/2018/11/27/traditional-medicine-lacks-stringent-regulations. Accessed Aug 16 2019; 2018.

Szabo CA. Patient page. Complementary/alternative medicine for epilepsy. Neurology. 2003;61(4):E7–8. https://doi.org/10.1212/wnl.61.4.e7 Pubmed:12939458.CrossRefPubMed

Skalli S, Zaid A, Soulaymani R. Drug interactions with herbal medicines. Ther Drug Monit. 2007;29(6):679–86. https://doi.org/10.1097/FTD.0b013e31815c17f6 Pubmed:18043467.CrossRefPubMed

Tan X, Makmor-Bakry M, Lau C, Tajarudin F, Raymond A. Factors affecting adherence to antiepileptic drugs therapy in Malaysia. Neurol Asia. 2015;20(3):235–41.

10.

Durón RM, Medina MT, Nicolás O, Varela FE, Ramírez F, Battle SJ, et al. Adherence and complementary and alternative medicine use among Honduran people with epilepsy. Epilepsy Behav. 2009;14(4):645–50. https://doi.org/10.1016/j.yebeh.2009.01.022 Pubmed:19435580.CrossRefPubMed

11.

Chui PL, Abdullah KL, Wong LP, Taib NA. Prayer-for-health and complementary alternative medicine use among Malaysian breast cancer patients during chemotherapy. BMC Complement Altern Med. 2014;14(1):425. https://doi.org/10.1186/1472-6882-14-425 Pubmed:25358688.CrossRefPubMedPubMedCentral

12.

Patterson C, Arthur H. A complementary alternative medicine questionnaire for young adults. Integr Med Insights. 2009;4:1–11. https://doi.org/10.4137/IMI.S2281 Pubmed:21614159.CrossRefPubMedPubMedCentral

13.

Chung WW, Chua SS, Lai PSM, Morisky DE. The Malaysian medication adherence scale (MALMAS): concurrent validity using a clinical measure among people with type 2 diabetes in Malaysia. PLoS One. 2015;10(4):e0124275. https://doi.org/10.1371/journal.pone.0124275 Pubmed:25909363.CrossRefPubMedPubMedCentral

14.

Andrade SE, Kahler KH, Frech F, Chan KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006;15(8):565–74. https://doi.org/10.1002/pds.1230 discussion 575 [Pubmed:16514590].CrossRefPubMed

15.

Dawood OT, Hassali MA, Saleem F. Factors affecting knowledge and practice of medicine use among the general public in the state of Penang, Malaysia. J Pharm Health Serv Res. 2017;8(1):51–7. https://doi.org/10.1111/jphs.12167.CrossRef

16.

Hovinga CA, Asato MR, Manjunath R, Wheless JW, Phelps SJ, Sheth RD, et al. Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: survey of patients with epilepsy and physicians. Epilepsy Behav. 2008;13(2):316–22. https://doi.org/10.1016/j.yebeh.2008.03.009 Pubmed:18472303.CrossRefPubMed

17.

Faught E, Duh MS, Weiner JR, Guérin A, Cunnington MC. Nonadherence to antiepileptic drugs and increased mortality: findings from the RANSOM study. Neurology. 2008;71(20):1572–8. https://doi.org/10.1212/01.wnl.0000319693.10338.b9 Pubmed:18565827.CrossRefPubMed

18.

Razali SM, Yassin AM. Complementary treatment of psychotic and epileptic patients in Malaysia. Transcult Psychiatry. 2008;45(3):455–69. https://doi.org/10.1177/1363461508094676 Pubmed:18799643.CrossRefPubMed

19.

Malaysia Healthcare. The healthcare system in Malaysia. 2020. https://www.mhtc.org.my/mhtc/2020/02/02/the-healthcare-system-in-malaysia/. Accessed Jan 03 2021.

20.

Tahir NM, Thomas P, Bakry MM, Ali A, Li SC. Cost-effectiveness of newer antiepileptic drugs (Aeds) for Management of Partial Epilepsy in children in Malaysia. Value Health. 2016;19(7):A875.CrossRef

21.

Red Cover. AIA 39 Critical Illnesses Insurance Plans Malaysia. Kuala Lumpur: AIA Insurance Malaysia;

22.

Sharma E, Dubey AK, Malhotra S, Manocha S, Handu S. Use of complementary and alternative medicines in Indian elderly patients. Natl J Physiol Pharm Pharmacol. 2017;7(9):929. https://doi.org/10.5455/njppp.2017.7.0411401052017.CrossRef

23.

Sirven JI, Drazkowski JF, Zimmerman RS, Bortz JJ, Shulman DL, Macleish M. Complementary/alternative medicine for epilepsy in Arizona. Neurology. 2003;61(4):576–7. https://doi.org/10.1212/01.wnl.0000073541.08356.47 Pubmed:12939447.CrossRefPubMed

24.

Liow K, Ablah E, Nguyen JC, Sadler T, Wolfe D, Tran KD, et al. Pattern and frequency of use of complementary and alternative medicine among patients with epilepsy in the midwestern United States. Epilepsy Behav. 2007;10(4):576–82. https://doi.org/10.1016/j.yebeh.2007.02.017 Pubmed:17459780.CrossRefPubMed

25.

McConnell BV, Applegate M, Keniston A, Kluger B, Maa EH. Use of complementary and alternative medicine in an urban county hospital epilepsy clinic. Epilepsy Behav. 2014;34:73–6. https://doi.org/10.1016/j.yebeh.2014.03.011 Pubmed:24726950.CrossRefPubMed

26.

Al Asmi A, Al Maniri A, Al-Farsi YM, Burke DT, Al Asfoor FM, Al Busaidi I, et al. Types and sociodemographic correlates of complementary and alternative medicine (CAM) use among people with epilepsy in Oman. Epilepsy Behav. 2013;29(2):361–6. https://doi.org/10.1016/j.yebeh.2013.07.022 Pubmed:24011398.CrossRefPubMed

27.

Bhalerao MS, Bolshete PM, Swar BD, Bangera TA, Kolhe VR, Tambe MJ, et al. Use of and satisfaction with complementary and alternative medicine in four chronic diseases: a cross-sectional study from India. Natl Med J India. 2013;26(2):75–8 Pubmed:24093979.PubMed

28.

Tandon M, Prabhakar S, Pandhi P. Pattern of use of complementary/alternative medicine (CAM) in epileptic patients in a tertiary care hospital in India. Pharmacoepidemiol Drug Saf. 2002;11(6):457–63. https://doi.org/10.1002/pds.731 Pubmed:12426930.CrossRefPubMed

29.

Naveen GH, Sinha S, Girish N, Taly AB, Varambally S, Gangadhar BN. Yoga and epilepsy: what do patients perceive? Indian J Psychiatry. 2013;55(Suppl 3):S390–3. https://doi.org/10.4103/0019-5545.116306 Pubmed:24049205.CrossRefPubMedPubMedCentral

30.

Kuan YC, Yen DJ, Yiu CH, Lin YY, Kwan SY, Chen C, et al. Treatment-seeking behavior of people with epilepsy in Taiwan: a preliminary study. Epilepsy Behav. 2011;22(2):308–12. https://doi.org/10.1016/j.yebeh.2011.06.034 Pubmed:21813332.CrossRefPubMed

31.

Islahudin F, Shahdan IA, Mohamad-Samuri S. Association between belief and attitude toward preference of complementary alternative medicine use. Patient Prefer Adherence. 2017;11:913–8. https://doi.org/10.2147/PPA.S132282 Pubmed:28546742.CrossRefPubMedPubMedCentral

32.

Koh HL, Teo HH, Ng HL. Pharmacists’ patterns of use, knowledge, and attitudes toward complementary and alternative medicine. J Altern Complement Med. 2003;9(1):51–63. https://doi.org/10.1089/107628003321536940 Pubmed:12676035.CrossRefPubMed

33.

Yeong S, Choong Y. Knowledge and characteristics of herbal supplement usage among community pharmacy customers in a Malaysian population. Complement Ther Med. 2017;35:92–108.CrossRef

34.

Warriner S, Bryan K, Brown AM. Women’s attitude towards the use of complementary and alternative medicines (CAM) in pregnancy. Midwifery. 2014;30(1):138–43. https://doi.org/10.1016/j.midw.2013.03.004 Pubmed:23631887.CrossRefPubMed

35.

Xue CC, Zhang AL, Lin V, Da Costa C, Story DF. Complementary and alternative medicine use in Australia: a national population-based survey. J Altern Complement Med. 2007;13(6):643–50. https://doi.org/10.1089/acm.2006.6355 Pubmed:17718647.CrossRefPubMed

36.

Shi L, Liu J, Koleva Y, Fonseca V, Kalsekar A, Pawaskar M. Concordance of adherence measurement using self-reported adherence questionnaires and medication monitoring devices. Pharmacoeconomics. 2010;28(12):1097–107. https://doi.org/10.2165/11537400-000000000-00000 Pubmed:21080735.CrossRefPubMed

37.

Wu JR, Lennie TA, Chung ML, Frazier SK, Dekker RL, Biddle MJ, Moser DK. Medication adherence mediates the relationship between marital status and cardiac event-free survival in patients with heart failure. Heart Lung. 2012;41(2):107–14. https://doi.org/10.1016/j.hrtlng.2011.09.009 Pubmed:22054720.CrossRefPubMed

38.

Ferrari CMM, de Sousa RMC, Castro LH. Factors associated with treatment non-adherence in patients with epilepsy in Brazil. Seizure. 2013;22(5):384–9. https://doi.org/10.1016/j.seizure.2013.02.006 Pubmed:23478508.CrossRefPubMed

39.

Zeber JE, Copeland LA, Pugh MJV. Variation in antiepileptic drug adherence among older patients with new-onset epilepsy. Ann Pharmacother. 2010;44(12):1896–904. https://doi.org/10.1345/aph.1P385 Pubmed:21045168.CrossRefPubMed

40.

Sweileh WM, Ihbesheh MS, Jarar IS, Taha ASA, Sawalha AF, Zyoud SH, et al. Self-reported medication adherence and treatment satisfaction in patients with epilepsy. Epilepsy Behav. 2011;21(3):301–5. https://doi.org/10.1016/j.yebeh.2011.04.011 Pubmed:21576040.CrossRefPubMed

41.

Bosak M, Słowik A. Use of complementary and alternative medicine among adults with epilepsy in a university epilepsy clinic in Poland. Epilepsy Behav. 2019;98:40–4.CrossRef

Title: Impact of complementary and alternative medicines on antiepileptic medication adherence among epilepsy patients
Authors: Muhammad Junaid Farrukh
Mohd Makmor-Bakry
Ernieda Hatah
Tan Hui Jan
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Antiepileptic Drugs
Epilepsy
Antiepileptic Drugs
Published in: BMC Complementary Medicine and Therapies / Issue 1/2021
Electronic ISSN: 2662-7671
DOI: https://doi.org/10.1186/s12906-021-03224-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of complementary and alternative medicines on antiepileptic medication adherence among epilepsy patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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