...but what happens when we don’t
quite get there?
The consequences of breakthrough seizures can be dire.
Substantial premature mortality from sudden unexpected death in epilepsy (SUDEP), status epilepticus, accidents, and suicide1
- In neurology, SUDEP is second only to stroke as a cause of total years of potential life lost1
- More than 3 convulsive seizures in a year increases risk of SUDEP by a factor of 15 6
- The risk of seizure-related injuries is 3.2 times greater in patients with convulsive seizures7
Relationship and Social
Depression, cognitive decline, and decline in social functioning 3,8,9
- Cognitive decline is strongly correlated with the number of convulsive seizures9
- Children with epilepsy have shown social competency deficiency, memory impairment, depression, and anxiety10,11
Job loss (with health insurance coverage interruptions), missed work due to comorbidities, and increased treatment costs 3,12
- Patients with breakthrough seizures had 8.1 times higher epilepsy-related costs12
- Cost of ER visits12
- Loss of ability to work (e.g. driver’s license suspension)3,13
A SINGLE MISSED DOSE
Patient nonadherence can be a serious obstacle to seizure freedom.
A single missed dose can cause a breakthrough seizure3,4 :
- Nearly 50% of people with epilepsy surveyed reported having a breakthrough seizure following a missed dose4,*
- In another survey, among people who had missed a dose in the past month, 51% had a seizure following a missed dose3
- 71% of people with epilepsy surveyed had missed at least 1 dose4,*
- 37% of patients with epilepsy missed a dose once a month on average14
- In one study, only 12% of nonadherent epilepsy patients felt comfortable telling their doctor about a missed dose3
- Nonadherence with AED therapy is most common amongst young people, especially teenagers15
*A 10-item, nationwide postal survey of 661 patients conducted between 2001 and 2002.
Target Breakthrough seizures
Give your patients the tools they need to aim for seizure freedom.
Consider a multi-pronged approach to improve adherence:
- Talk about any breakthrough seizures they may be having, and encourage them to report seizures
- Work with the patient to create a comprehensive, realistic plan of action for improving adherence3,5
- Develop reminder strategies to help them increase adherence and decrease seizure frequency, such as:3,5
- Using a pillbox
- Getting medication reminders via app or email
- Displaying their medication schedules and checking off each dose
- Adjust the treatment regimen to fit your patient's lifestyle (fewer daily doses, once-daily dosing, alternative formulations [chewable tablet, oral suspension, sprinkle capsules])5,16
- Consider medication engineered for sustained release or with a long half-life to help achieve and sustain stable, steady-state plasma levels when adherence is a concern5,17