ABSTRACT
Compliance can be dened as “the extent to which a person’s behavior (in terms of medications, following diet, or executing lifestyle changes) coincides with medical or health advice” (Haynes 1979). Even conning the discussion to noncompliance with drug
51.1 Introduction 845 51.2 What Is Compliance and Noncompliance? 845 51.3 How Can Compliance Be Assessed? 846 51.4 How Could Poor Compliance Relate to the Risk of SUDEP? 846 51.5 Postmortem Drug Levels 847 51.6 Other Methods to Assess Nonadherence 849 51.7 Conclusions 849 References 850
therapy, this remains a major issue in medicine in general. It has been estimated that half of patients for whom appropriate therapy is prescribed fail to receive full benet because of inadequate adherence to treatment (Haynes 1979). Epilepsy is no exception. A consensus document was published aer the First International Workshop on Compliance in Epilepsy (Leppik and Schmidt 1988). It was suggested that compliance be categorized by three dimensions: (1) type of behavior (consistent overcompliers, consistent undercompliers, or those who are irregular in behavior); (2) extent of compliance (ranging from those who do not take the medication at all to those who take every dose as prescribed); and (3) whether the patient is intentionally noncompliant or not. Cramer and collaborators (2008) have stressed the importance of distinguishing between medication compliance and medication persistence, in which the latter refers to the act of continuing the treatment for the prescribed duration.
