通院てんかん患者の服薬状況--とくに怠薬者の特徴点について

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Epilepsy is mainly treated with chontinuous administration of anti-epileptic agents. Accordigly, it is necessary to watch“drug compliance” as one of the factors greatly affecting the carrying on of normal everyday life and control of epileptic seizures. In the present study, 150 patients were randomly selected out of 320 epileptic ambulatory patients treated periodically with anti-epileptic agents at the Out-Clinic, Department of psychiatry, Showa University School of Medicine. By the use of a questionnaire-method over a period of 6 months, interviews were conducted with subjects and their family members. At that time, 51 (34.0%) had ceased taking medication. Then, a significant parallel relationship was observed in drug-taking attitude and therapeutic efficacy. The relationship between the feature of a patient who failed to take the drug and therapeutic efficacy was as follows : Many patients were over 40 years of age. No parallel relationship could be found between the age-factor and therapeutic efficacy. In clas-sification of epileptic seizures, many showed partial seizures, and therapeutic efficacy was poor. A significantly large number of seizures were observed in patients with affected temporal lobes, and their therapeutic results were poor. A significantly large number of seizures of seizurts were observed in patients affected by personality or character disorders, and therapeutic efficacy was poor. Less of the patients failed to take their medication when a physician was directly in charge at the Out-Clinic, and it might be possible to prevent drug defaulting by making the patient consult with a specific physician at each visit; however, in view of therapeutic efficacy, uncontrolled cases of seizures would have consulted a specific physician. Family members were often helpful in preventing patients from defaulting on taking their medication. Epileptic seizures were more often observed in those patients living alone and unemployed. Also, in their cases, efficacy of treatment was poor. In addition, background was greatly affected by family relationships in some cases; thus, the report suggests the necessity of social welfare assistance for these patients. Among the reasons for defaulting on taking medication, the first was the concern about the occurrence of side-effects; the most noteworthy among these was concern over possible teratogenic effects of the drug on the part of women in the child-bearing years. The second major reason was based on“Epileptischer Optimismus”. Considering the above items, by establishing a clinical regimen for epileptic patients, it is possible not only to control seizures, but also to maintain favorable adaptation to society, thereby, a sizeable contribution can be made to the treatment of epileptic patients.
学校法人昭和大学・昭和医学会の論文

通院てんかん患者の服薬状況--とくに怠薬者の特徴点について

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