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Adherence to antiepileptic drugs for epileptic patients attending neurology outpatient department in tertiary care center – A prospective observational study

Dhivya Devi T, Shanthi M, Ezhil Ramya J.


Background: Poor adherence to prescribed regimens can result in serious health consequence. Antiepileptic medication non-adherence leads to disease progression, reduced functional abilities, lower quality of life. Medication non-adherence can have negative consequences not only for the patient but also for the provider, the physician, and even the medical researchers who are working to establish the value of the medication on the target population.

Aim and Objective: This study aims to evaluate adherence of study participants on antiepileptic medication using Morisky Medication Adherence Scale (MMAS-8) and to identify factors associated with non-adherence and its impact on quality of life.

Materials and Methods: The study was approved by the Institutional Ethics Committee. The prospective study was conducted for a period of 2 months from March 2019 to April 2019 in neurology outpatient department in Tirunelveli Medical College Hospital. Patients of both sexes more than 18 years of age who were diagnosed as epilepsy and on antiepileptic medication therapy for at least 3 months were included as study participants. Data were collected from sample of 110 patients. Adherence was measured using MMAS-8.

Results: The observational study recruited 110 participants which included 69 (63%) males and 41 (37%) females, 47 (43%) on monotherapy and 63 (57%) on combination therapy, 92 (84%) generalized seizures and 18 (16%) focal seizures, 69 (63%) highly adherent, 18 (16%) medium adherent, and 23 (21%) poorly adherent to antiepileptic medication. Forgetfulness (46%) was the most common reason within non-adherent patients and statistical significance was noted. Among the non-adherent patients, recurrence of seizures occurred in 66% of patients that affected daily activities, 10% of them experienced injury due to seizures, 17% of patients discontinued studies, and 7% discontinued job which impacted their quality of life.

Conclusion: The current study shows that 63% of epileptic patients were highly adherent to treatment. Adverse events were experienced by one-third of the non-adherent patients. Overcoming non-adherence done by appropriate counseling, health education, and explaining consequences of poor adherence to the patients.

Key words: Adherence; Morisky Medication Adherence Scale-8; Antiepileptic Medication; Adverse Effects; Quality of Life

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