White Coat Adherence over the First Year of Therapy in Pediatric Epilepsy

• Published in: The Journal of pediatrics Vol. 161; no. 4; pp. 695 - 699.e1
• Main Authors: Modi, Avani C., Ingerski, Lisa M., Rausch, Joseph R., Glauser, Tracy A., Drotar, Dennis
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.10.2012; Mosby, Inc; Elsevier
• Subjects: Anticonvulsants; Anticonvulsants - therapeutic use; Biological and medical sciences; caregivers; Child; Child, Preschool; children; Communication; decision making; drug therapy; epilepsy; Epilepsy - drug therapy; Female; General aspects; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Health participants; Humans; Logistic Models; Male; Medical sciences; monitoring; Nervous system (semeiology, syndromes); Neurology; Office Visits; Patient Compliance; Patient Compliance - statistics & numerical data; Pediatrics; prospective studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; regression analysis; statistics & numerical data; therapeutic use; MEMS; Medication event monitoring systems; Human; Pediatrics; Nervous system diseases; Treatment; Health staff; Epilepsy; Central nervous system disease; Treatment compliance; Adhesion; Child; Cerebral disorder
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2012.03.059

To examine white coat adherence over time in children with epilepsy. This was a longitudinal prospective study to examine medication adherence prior to and following consecutive clinic visits over a 13-month period in 120 children with newly diagnosed epilepsy (Mage = 7.2 ± 2.9 years; 38% female) and their caregivers. Electronic monitors were used to assess adherence and ordinal logistic regression models were employed. Results demonstrated white coat adherence, with adherence increasing during the 3 days preceding clinic visits. Data also revealed a significant interaction, whereby adherence increased following initial clinic visits, but decreased following the last clinic visit. White coat adherence occurs for children with newly diagnosed epilepsy. Increased awareness of white coat adherence has important implications for clinical decision-making and should be examined in other pediatric populations. Increased monitoring of medication patterns can help clinicians avoid unnecessary changes to the treatment regimen. Interventions targeting improved communication around adherence behaviors are necessary to maximize therapy benefits.