There are limitations inherent in collecting self-reported
data at the beginning of phase 1 and using self-reported data
for CG members in the subsequent follow-up period,
although we collected objective data from the IG through
the epilepsy tracking card during the follow-up period.
Other methods, such as the evaluation of serum medication
levels or the use of electronic monitoring caps, might be
more objective (Hess et al., 2006; Paschal et al., 2008). The
nonadherence scoring system used in our survey varied
from the measures used in other studies because there is no
gold standard for measuring nonadherence. In the present
study, the intervention was developed for local practicality
based on the experience of experts, but it lacks adequate evidence
to prove its effectiveness. Although the local physicians
who were responsible for the preliminary evaluation
of patients were trained before the project started, there may
still have been differences in individual knowledge about
epilepsy and the adherence to the intervention procedures
and follow-up protocol, even though all local physicians
were required to qualify to participate in the intervention to
minimize these potential biases.