Health disparities in medication adherence between African-Americans and Caucasians with epilepsy.

Objective: The goal of this study was to determine whether racial disparities exist with respect to adherence to antiepileptic drugs (AEDs) in patients with epilepsy.

Method: We reviewed the pharmacy and clinical records of 108 patients with epilepsy who were part of the indigent care program at Shands-Jacksonville. We determined the medication possession ratio (MPR) for each patient and obtained other demographic and clinical variables. Using univariate analysis we determined which variables were associated with the MPR and used multiple linear regression to determine those that best predicted the MPR.

Results: Compared with Caucasians, African-Americans had poorer (lower) MPRs (0.872 for Caucasians vs 0.796 for African-Americans, P=0.02). Age, gender, high school education, epilepsy classification, seizure freedom, number of AEDs, AED copayment scheme, and number of refills were not significantly affected by race. On stepwise multiple linear regression, race alone best predicted the MPR.

Conclusion: Compared with Caucasians, African-Americans have significantly poorer AED adherence, as measured by the MPR.