Associations Between Child Knowledge and Worry and Medication Adherence to Antiepileptic Drugs

Associations Between Child Knowledge and Worry and Medication Adherence to Antiepileptic Drugs

Author: 
Gwendolyn Avington
Program of study: 
D.H.A.
Abstract: 
Epilepsy affects 50 million people worldwide including 15 million children. Pediatric epilepsy is a serious neurological disorder characterized by recurrent seizures. Antiepileptic Drugs are frequently used in the treatment and control of epilepsy. However, the high incidence of AED nonadherence has contributed to the rising costs associated with treating epileptic patients. This study examined associations between two potential psychosocial barriers (e. g. child knowledge and child worry/fear) and AED nonadherence in 6-12 years old epilepsy patients a year following disease diagnosis. Several potential confounders that may affect adherence behavior were also examined. Modifiable (socioeconomic status) and non-modifiable (race) confounders alike were evaluated. This was a cross-sectional quantitative secondary analysis to a larger prospective study, which sought to look at child AED adherence from the parental/caregiver perspective. To date no known studies have been done that examined child-knowledge and child-worry/fear and their effect on AED adherence from the child’s perspective 13-months post diagnosis. No association was found between child knowledge and child worry/fear and AED medication adherence 13-months post epilepsy diagnosis. In fact, the only predictor of adherence in this study was Duncan Score, a measure of socioeconomic status. Future studies examining the combined effect of parent and child on adherence is needed. Further, an effort to better understand how to educate parents and children living in lower socioeconomic families is needed to achieve the common goal of improved seizure control for all children.
Dedication: 
I would like to dedicate this to my children, Angelika D. Gulley, Lee D. Gulley, the late Phillip D. Gulley, and my grandson Cam’Ron B. Gulley. My son’s unexpected death at 6 months old and my grandson’s diagnosis of pediatric epilepsy have been driving forces in my desire to understand chronic diseases, especially epilepsy. My children have stood by me through this tough journey, often giving up time with me, encouraging me to keep going, and doing small things to ensure I could successfully achieve my doctoral degree and subsequently set myself to be in a position to do further research as I desire.
Acknowledgements: 
I would like to acknowledge and thank the following individuals for their support, critiques, expertise, positivity, and patience. God, first and foremost, for guiding me through his spirit to this place he has preordained in my life. My children for their tireless support, comfort, and encouragement. My dad, the late LeRoy Avington, who told me at the age of 6 that he hoped I would grow up to be a doctor or teacher. My biological mom, Fay Doris Avington, who taught me the value of a hard work ethic and determination, even in the face of adversity. Also, my spiritual mom, Doris Juanita Smith Brown, who has prayed for me in my darkest hours and encouraged me to elevate myself both spiritually and on my career path. David L. Bergeron, who meet with me at the Ram to brain storm about my dissertation topic. You promised to stand by me throughout the doctoral process and you have. My academic team and support throughout my journey at the University of Phoenix. Kenni Schauer, my first facilitator at the university, who guided me through that first class after I became a team of one on the final project to complete the class for a grade. Eric Peterson, who was my beginning enrollment counselor to the Doctorate program. He called me for the first time “Dr. Avington” in that intake interview. My take away, was he was daring me to see the vision that said yes, I am. He moved to a new position, but left me in the hands of a woman that he had mentored, telling her to take care of me. Carolyn Nellis has done just that, she has been a sounding board, a director to the right people to discuss barriers to my success, a friend, and cheerleader in chief for me.