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Personalized adherence interventions using medication adherence technologies in polypharmacy management in epilepsy: An interprofessional case report

Year: 2025

Type: article

Abstract: • This case report describes clinical findings in a single individual. • Personalized adherence interventions improved taking adherence from 64% to 93%. • Adherence tended to decrease once adherence reminders were removed. • Electronic monitoring in general enables insight into long-term adherence behavior. • Assessing personal circumstances can help identify strategies to improve adherence. We describe a male patient with symptomatic multifocal epilepsy struggling with medication adherence. He accepted escalating adherence interventions with conventional dosing aids such as pillboxes and medication adherence technologies (MATech) including a smart medication dispensing and adherence device (SMAD). Adherence metrics and drug levels were continuously monitored by electronic monitoring (EM) and therapeutic drug monitoring (TDM). Initially, adherence metrics with pre-filled punch cards supplied by a community pharmacy showed 64% taking adherence, 63% timing adherence, and 47% correctly dosed days, including a five-day medication holiday. Adherence improved with a pharmacy-filled SMAD, reaching 93% taking adherence, 90% timing adherence, 86% correctly dosed days, and no medication holiday. No epileptic seizures were noticed during periods with EM. The patient was satisfied with the SMAD while struggling with other adherence tools. Adherence tended to decrease once adherence reminders were removed. In conclusion, we emphasize the importance of personalized adherence strategies and shared decision-making. This case highlights the positive impact of an interprofessional adherence improvement program, integrating efforts from researchers, neurologists, and community pharmacists.

Source: Epilepsy & Behavior Reports

DOI: 10.1016/j.ebr.2025.100767

Authors: Micheline C. Sarbach, Stephan Rüegg, Samuel S. Allemann, Isabelle Arnet

Institutions: University of Basel, University Hospital of Basel

Language: English

Topic: Medication Adherence and Compliance

Subfield: Family Practice

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,630