Supporting Treatment Adherence Regimens (STAR) for young children with epilepsy

What is it about?

The current study explores the effects of a family-tailored education and problem solving intervention, Supporting Treatment Adherence Regimens (STAR) in young children with newly diagnosed epilepsy. Participants were randomized to either the STAR intervention, or a control group providing educational information as it relates to seizure activity and overall functioning (e.g., psychosocial comorbidities, seizure safety, sleep hygiene, academic concerns) . The STAR intervention consisted of several sessions with a trained masters or doctoral level interventionist aimed at learning and practicing a problem-solving approach to addressing adherence barrier(s) experienced by the family, telephone follow-ups on the success of solution implementation, and booster sessions to review information, problem solve new barriers, and plan for the future. Results across both groups were examined to compare differences in antiseizure medication adherence to medical regimens, seizure outcomes, and quality of life. Results suggested the STAR intervention group had significantly greater adherence than the education only control group at 12-month follow-up. No differences were found based on seizure outcomes or health-related quality of life.

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Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

Epilepsy is a common childhood condition primarily treated with antiseizure medications. Unfortunately, how effective the medication is for managing seizures is significantly diminished by suboptimal adherence. Consequences of suboptimal adherence not only include triple the risk of seizure activity, but also poorer quality of life, clinical decision making, and higher healthcare utilization and costs. Improving adherence to antiseizure medications is therefore critical for youth with epilepsy. Findings from the STAR trial suggest the intervention may optimize adherence in the first year of epilepsy in youth who are newly diagnosed. Specific strengths of the current study also include the tailored nature of the intervention (e.g., tailored to specific adherence barriers identified by the family, informed by individualized adherence feedback reports) and the use of evidence-based problem solving approaches. The current study has also fueled future research, including the development of an adaptive mobile health (mHealth) adherence intervention derived from STAR.