An Evaluation of Factors Influencing Adherence to Antiepileptic Medications (AEDs): A Cross-sectional Hospital-Based Study—An Overview and Recommendations to Improve

Objective: Long-term treatment by antiepileptic drugs (AEDs) is vital for effective control of seizures in patients with epilepsy (pWE). The present study was performed to measure extent and factors influencing adherence to AEDs.

Methods: The present study was a prospective, cross-sectional study, involving PWE reporting at a tertiary care hospital. The extent of adherence to AEDs was measured using Morisky Medication Adherence Scale (MMAS). Data from 451 patients with confirmed diagnosis of epilepsy were subjected to univariate analysis using Chi-square test to observe association between AED adherence and different variables. Further the predictors of adherence were analyzed using binary regression analysis.

Results: There were 251 (55.7%) male and 198 (43.9%) female PWE. The extent of adherence to AEDs was high among 326 (72.3%) and low in 125 (27.7%). The socioeconomic status (p = 0.043) and type of epilepsy (p = 0.033) were found to be significantly associated with AED adherence. However, no significant difference was observed between adherence and age, gender, marital status, epilepsy duration, number, and type of AEDs, and occurrence of adverse drug reactions. Patients with focal epilepsy and those from the middle/lower to middle socioeconomic classes were less likely to be nonadherent. The primary reason for nonadherence was forgetfulness.

Conclusion: Forgetfulness was a primary preventive factor for AED nonadherence. We recommend methods to improve the same using multiple measures to maximize adherence and minimize development of pharmaco-resistance to AEDs in PWE.