FAMILY DYNAMICS AND MEDICATION COMPLIANCE IN TEENAGED EPILEPTICS

Abstract

Optimal seizure control for a teenager epileptic requires compliance with the prescribed regimen. We tested the hypothesis that poor medication compliance is associated with parental restrictiveness and family disharmony, since both thwart the attainment of the teens' developmental goals of independence and acceptance in the family. Twenty-five epileptic young people (ages 9-17 yrs. being treated with phenobarbital were observed for one year). Teens' perceptions of their Personal Freedom (TPF) in daily activities and Teens' views of harmony in their Family Relations (TFR) were measured using scales from the California Test of Personality. Similar scales assessed Parents' views of the teens' Personal Freedom (PPF) and Parents' views of Family Relations (PFR). Saliva Compliance Scores (SCS) were calculated from phenobarbital levels in saliva samples obtained monthly (by mail from the subjects' homes and at clinic and home visits). SCS was correlated with TPF (r=0.38,p=0.06), PPF (r=0.52, p=0.007), TFR (r=0.39, p=0.04), and PFR (r=0.40,p=0.04). The SCS was more highly correlated with TPF after partialling out the effects of age (r=0.41,p=0.04), and sex (r=0.42,p=0.03). These family issues have potential causal relationships to medication compliance in epileptic youth. Clinicians should monitor and address family-adolescent interaction in order to assure the desired outcome in the treatment of adolescents with epilepsy.