Adherence to Antiepileptic Therapy in Adults

J Neurosci Rural Pract. 2017 Jul-Sep;8(3):417-420. doi: 10.4103/jnrp.jnrp_392_16.

Abstract

Context: Epilepsy is a neurological disorder affecting 70 million worldwide. The high incidence of relapse can be attributed to nonadherence, thus increasing the incidence of refractory epilepsy to 10%-20%.

Aims: This study was planned to determine rate of adherence and factors affecting adherence using Antiepileptic Adherence Questionnaire and Baseline Adherence Questionnaire.

Materials and methods: A cross-sectional, questionnaire-based study was carried out at a rural hospital from May to September 2015. Patients of either gender aged 18-60 years, diagnosed with epilepsy were interviewed after they consented. Patient details, responses to questionnaires were collected and analyzed using descriptive statistics.

Results: Among the participants, 67.8% were males and 32.2% were females with the mean age of 38.3 ± 13.9 years. The response rate was 75% (90/120). The majority were literate (64.4%) and employed (58.9%). The duration of disease was <5 years in most individuals; 50% were highly, 21.1% moderately, and 28.9% nonadherent to treatment. Among the highly adherent, 66.7% never skipped medications because they had knowledge of the disease and treatment. More than 97% were satisfied with the social support, and 89% expressed that their family and friends reminded them to take medications. Patients who were nonadherent to treatment attributed it to the lack of knowledge of the disease (57%) and treatment (96%). Reasons for nonadherence were patients assumed drug was harmful, felt cured of the disease, and wanted to avoid side effects.

Conclusion: Nearly, 70% expressed the lack of satisfactory support from the social circle. We observed that nearly seventy percent epileptic patients were moderate-highly adherent. Nonadherence was attributed to patient feeling cured of disease and assuming medications to be harmful. Counseling of patients will help in adherence to treatment.

Keywords: Adherence; antiepileptics; questionnaire.