% 0期刊文章%塞缪尔·w·特曼%一个卡罗尔·e·韦斯利·T·克尔%《% %克洛伊·希尔一扎卡里·A·Marcum %詹姆斯·f·伯克% T坚持抗癫痫和其他药物在美国医疗保险受益人和没有癫痫% D R 10.1212 / WNL 2022%。0000000000013119 % J首页神经病学% P e427-e436 % V 98% N 4% X背景和目的本研究的目的是比较坚持抗癫痫药物(asm) vs non-ASMs癫痫患者中,评估依从性变化的程度是由于个体之间的差异和个体的药物类之间癫痫,并比较在vs没有癫痫患者依从性。这是一个回顾性队列研究方法使用医疗保险。我们包括受益人与癫痫(≥1 ASM,加上ICD-9-CM诊断代码)和20%的随机样本没有癫痫。坚持对每个药物类的比例衡量天覆盖(PDC)在2013年到2015年。我们用斯皮尔曼相关系数,科恩κ统计,和多级逻辑回归。结果有83819与癫痫受益者。斯皮尔曼相关系数和ASM PDCs之间的每个5 non-ASM PDCs范围从0.44到0.50;科恩κ范围从0.33到0.38;和within-person差异的PDC ASM - PDC的non-ASM都具有统计学意义(p < 0.01),尽管平均差异都非常接近于0。百分之五十四的变异在药物依从性是由于个体间的差异。调整预测概率遵循如下:asm 74%(95%可信区间[CI] 73% - -74%),质子泵抑制剂74% (95% CI 74% - -74%),降压药77% (95% CI 77% - -78%),选择性5 -羟色胺再摄取抑制剂77% (95% CI 77% - -78%),他汀类药物78%(95%可信区间78% - -79%),左旋甲状腺素82% (95% CI 81% - -82%)。 Adjusted predicted probabilities of adherence to non-ASMs were 80% (95% CI 80%–81%) for beneficiaries with epilepsy vs 77% (95% CI 77%–77%) for beneficiaries without epilepsy.Discussion Among individuals with epilepsy, ASM adherence and non-ASM adherence were moderately correlated, half of the variation in adherence was due to between-person rather than between-medication differences, adjusted adherence was slightly lower for ASMs than several non-ASMs, and epilepsy was associated with a quite small increase in adherence to non-ASMs. Nonadherence to ASMs may provide an important cue to the clinician to inquire about adherence to other potentially life-prolonging medications as well. Although efforts should focus on improving ASM adherence, patient-level rather than purely medication-specific behaviors are also critical to consider when developing interventions to optimize adherence.ASM=antiseizure medication; AUC=area under the curve; CI=confidence interval; ICC=intraclass correlation coefficient; ICD-9-CM=International Classification of Disease, 9th Revision, Clinical Modification; OR=odds ratio; PCD=proportion of days covered; PPI=proton pump inhibitor; SSRI=selective serotonin reuptake inhibitor %U //www.ez-admanager.com/content/neurology/98/4/e427.full.pdf