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Use of complementary and alternative medicine and adherence to antiepileptic drug therapy among epilepsy patients: a systematic review

Authors Farrukh MJ, Makmor-Bakry M, Hatah E, Tan HJ

Received 3 July 2018

Accepted for publication 8 August 2018

Published 11 October 2018 Volume 2018:12 Pages 2111—2121


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Video abstract presented by Farrukh et al.

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Muhammad Junaid Farrukh,1 Mohd Makmor-Bakry,1 Ernieda Hatah,1 Hui Jan Tan2

1Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Purpose: To identify the use pattern of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy.
Method: Potential studies were identified through a systematic search of Scopus, Science Direct, Google Scholar, and PubMed. The keywords used to identify relevant articles were “adherence,” “AED,” “epilepsy,” “non-adherence,” and “complementary and alternative medicine.” An article was included in the review if the study met the following criteria: 1) conducted in epilepsy patients, 2) conducted in patients aged 18 years and above, 3) conducted in patients prescribed AEDs, and 4) patients’ adherence to AEDs.
Results: A total of 3,330 studies were identified and 30 were included in the final analysis. The review found that the AED non-adherence rate reported in the studies was between 25% and 66%. The percentage of CAM use was found to be between 7.5% and 73.3%. The most common reason for inadequate AED therapy and higher dependence on CAM was the patients’ belief that epilepsy had a spiritual or psychological cause, rather than primarily being a disease of the brain. Other factors for AED non-adherence were forgetfulness, specific beliefs about medications, depression, uncontrolled recent seizures, and frequent medication dosage.
Conclusion: The review found a high prevalence of CAM use and non-adherence to AEDs among epilepsy patients. However, a limited number of studies have investigated the association between CAM usage and AED adherence. Future studies may wish to explore the influence of CAM use on AED medication adherence.

medication adherence, AED, epilepsy, complementary and alternative medicine, non-compliance, CAM, seizure

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