Impact of Repeated Health Education Delivery on Antiepileptic Drug Adherence in People with Chronic Epilepsy in the Community

Introduction: Epilepsy is a chronic disorder with long-term treatment, and adherence to antiepileptic drugs decreases with time. Repeated counseling with adherence reinforcement may prevent this adherence decay.

Objective: To study the impact of repeated health visits and patient education on adherence to antiepileptic drugs in people with chronic epilepsy in the community.

Methods: The setting of the study was provided by community care trial of home-based care delivered by primary health care workers versus routine clinic-based care. We studied the association between monthly pill counts and self-reported adherence questionnaire score with age, gender, religion, ethnic origin, education, occupation, monthly family income, and socioeconomic class. In addition, we created a dummy variable, which represented baseline scores for each subject.

Results: There was considerable inter individual variations on pill count and SRMS score. Overall, lag SRMS, religion, ethnic origin, and monthly family income determined adherence status. A steady increase in the proportion of people with appropriate pill count was observed in the home-based care group but not in the clinic-based care group.

Conclusion: Treatment adherence varies considerably between individuals and is influenced by individual behavior. However, repeated adherence reinforcement by primary health care workers may lead to improvement in adherence.