American Board of Internal Medicine (ABIM) Certification Practice Exam

In older patients, which characteristic of antiepileptic drugs (AEDs) improves adherence to treatment?

1. Higher efficacy

2. Lower cost

3. Fewer adverse effects

4. Better availability

The correct answer is: Fewer adverse effects

The characteristic of antiepileptic drugs that improves adherence to treatment in older patients is fewer adverse effects. Older adults often have a higher burden of comorbidities and may be more sensitive to the side effects of medications. When choosing AEDs, options that minimize the risk of adverse events are crucial because they can significantly affect an older patient's quality of life and willingness to continue treatment. If an AED has a lower incidence of side effects, patients are more likely to adhere to the prescribed regimen as they may experience fewer negative impacts on their daily lives. In addition to this, while higher efficacy is essential for effective seizure control, it does not directly correlate with adherence if the patient cannot tolerate the medication due to side effects. Lower cost and better availability are also important considerations; however, they do not have the same direct impact on adherence as the tolerability of the medication does. Thus, the emphasis on fewer adverse effects highlights a significant factor that not only influences treatment success but also encourages older patients to remain committed to their medication regimen.