Compliance with appointments and medications in a pediatric neurology clinic at a University Hospital in Riyadh, Saudi Arabia

OBJECTIVE: The objectives of the study are to estimate the rate of epileptic patients' compliance with appointments and medications in a pediatric neurology clinic. Also to study the factors associated with non-compliance and to determine the parents' perceived reasons for non-compliance with appointments.

METHODS: It is a prospective study in which 147 epileptic children who attended the neurology clinic during the first 12-months of the study period were included. Patients were recruited into the study after their parents were interviewed using a detailed questionnaire; their compliance with appointments was monitored prospectively over at least a one year from their recruitment into the study. The parents of the other 70 patients who did not attend the clinic were telephoned. Only 32 replied and were asked about the reasons for non-attendance to the clinic.

RESULTS: Eighty-six percent of the patients' parents stated that they were complying with the medications while only 53% of them did not miss any appointment to the clinic during the study period. Compliers with appointments were more likely to comply with their medications too. Children with grand-mal epilepsy and absence seizures were found to be more likely to comply with taking medications than patients with febrile, rolandic and myoclonic seizures (P=0.01). Health belief model factors associated with non-compliance were 1. Children encountering side effects from their medications 2. Parents who were not satisfied with the provided services 3. Parents who thought that alternative medicine is more effective than traditional medicine 4. Parents who think that their children are not susceptible. Patients' perceived main reasons for non-compliance were wrongly registered appointments (27.5%), forgetfulness (22.5%) and busy parents.

CONCLUSION: Failure to keep the clinic appointment is an indicator of poor compliance with medications. A telephone call is recommended to reduce the role of clinic non-compliance. Developing a questionnaire form to investigate parents health belief model could be used routinely by social workers and then health education could be tailored for each patient and parent.