Antiepileptic Drug Adherence and Associated Factors Among Adult Epileptic Patients Attending Neurology Referral Clinic in Adama Hospital Medical College, Ethiopia
Clinical Neurology and Neuroscience
Volume 3, Issue 4, December 2019, Pages: 93-99
Received: Oct. 26, 2019;
Accepted: Nov. 28, 2019;
Published: Dec. 11, 2019
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Tadesse Seda, Department of Neurology, Adama Hospital Medical College, Adama, Ethiopia
Background- Adherence to anti epileptic medication therapies is a primary determinant of treatment success. Non-adherence to the treatment attenuates most clinical benefits and therefore reduces the overall effectiveness of health systems. However, to our knowledge there is study conducted to what extent epileptic patients adhere to their treatment and factors which affects adherence. Hence, this study aimed to assess antiepileptic drug adherence and factors associated with it among Adult Epileptic Patients Attending Neurology Referral Clinic in Adama Hospital Medical College. Methods- We conducted a cross-sectional hospital based study on epileptic patients who are on antiepileptic medications from April 10 to July 10, 2019. Data were collected from patient above 18 years old. Adherence was measured using the four-item Morisky’s medication adherence scale. All consecutive patients coming to Neurology referral clinic during the study period were interviewed until the calculated sample size (322) was obtained. We collected patient demographics, clinical related, questions related to drug intake and adherence. Both Bivariate and multivariate analyses were performed to test for associations. Odds ratio was used to assess strength of association, and level of association determined by p. value <0.05%. Result- out of a total of 340 participants, 322 were willing to participate. Of the 194 participants, 109 (56.2%) were males. The mean age of the participants was 32.10 ± 7.37 years; range 18-56 years. The majority, 61.4% of the participants were taking a single antiepileptic drug. Over all 67.3% (95% CI: 62.9%, 71.9%) of the participants were adherent to their treatment. The most common reported reasons for non-adherence were financial or cost of drugs 39.01 followed by distance 38.5%. Factors which have significant association with adherence to antiepileptic treatment were: being female (AOR=2.04, 95% CI=1.07, 3.87), respondents in primary education (AOR= 2.74, 95% CI= 1.01, 7.46), married (AOR= 3.65, 95% CI= 1.34, 9.89) cost of drug 500 to 999 birr (AOR= 2.59, 95% CI= 1.03, 6.45) and one thousand and more (AOR= 5.14, 95% CI= 2.49, 10.61). Conclusion: Only 67.2% of the respondents were adhered to their treatment which is low when compared with more than 95% standard adherence may be necessary to adequately suppress the epileptic seizures.
Antiepileptic Drug Adherence and Associated Factors Among Adult Epileptic Patients Attending Neurology Referral Clinic in Adama Hospital Medical College, Ethiopia, Clinical Neurology and Neuroscience.
Vol. 3, No. 4,
2019, pp. 93-99.
England MJ, Liverman, C. T., Schultz, A. M., Strawbridge, L. M. Epilepsy across the spectrum: promoting health and understanding. A summary of the Institute of Medicine report. Epilepsy Behav. 2012; 25: 266-76.
Berg AT, Jallon, P., Preux, P. M. The epidemiology of seizure disorders in infancy and childhood: definitions and classifications. Handb Clin Neurol. 2013; 3: 391-8.
World Health Organization (WHO) G. Atlas: epilepsy care in the world. 2005.
Ngugi AK BC, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: A meta-analytic approach. Epilepsia. 2010; 51 (5): 883-90.
Epilepsy ILA. Quality of Life: General Considerations. Epilepsia. 2003; 44 (6): 57-8.
H S. Novel aspect of epilepsy. In tech 2011.
JH C. Epilepsy treatment in sub-Saharan Africa: Closing the gap. Afr Health Sci. 2012; 12 (2): 186- 92.
Prince MJ AD, Castro-Costa E, Jackson J, Shaji KS. Packages of Care for Dementia in Lowand Middle-Income Countries. PLoS Med. 2009; 6 (11).
Baskind R BG. Epilepsy-associated stigma in sub-Saharan Africa: The social landscape of a disease. Epilepsy Behav. 2005; 7: 68-73.
Rout K KM. A review on antiepileptic agents, current research and future prospectus on conventional and traditional drugs. IJPSRR. 2010; 3 (2): 19-23.
Sweileh WM IM, Jarar IS, Taha ASA, Sawalha AF, Zyoud SH, et al. Self-reported medication adherence and treatment satisfaction in patients with epilepsy. Epilepsy Behav Elsevier Inc. 2011; 21 (3): 301-5.
Faught E DM, Weiner JR, Guerin A Cunnington MC. Impact of nonadherence to AEDs on health care utilization and cost. Epilepsia. 2008; 50 (3): 5019-21.
Getachew H DH, Awol SS, Abdi AA, Mohammed MA. Medication adherence in epilepsy and potential risk factors associated with non-adherence in tertiary care teaching hospital in southwest Ethiopia. GMJ. 2014; 20 (1): 59-65.
Liu J LZ, Ding H, Yang X. Adherence to treatment and influencing factors in a sample of Chinese epilepsy patients. ED. 2013; 15 (3): 289-94.
Eatock J BGd. Managing patient adherence and quality of life in epilepsy. Neuropsychiatric Disease and Treatment 2007; 3 (1): 117-31.
Jones RM, Butler, J. A., Thomas, V. A., Peveler, R. C., Prevett, M. Adherence to treatment in patients with epilepsy: associations with seizure control and illness beliefs. Seizure. 2006; 15: 504-8.
Egenasi C SW, Raubenheimer JE. Beliefs about medication, medication adherence and seizure control among adult epilepsy patients in Kimberley, South Africa. SAFP. 2015; 57 (5): 326-3.32.
Ferrari CM SR, Castro LH Factors associated with treatment non-adherence in patients with epilepsy in Brazil. Seizure 2013; 22 (5).
Morisky DE LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence Med Care. 1986; 24: 67-74.
Wong MC JJ GS. Antihypertensive drug adherence among 6408 Chinese patients on angiotensin- converting enzyme inhibitors in Hong Kong: a cohort study. J Clin Pharmacol. 2010; 50 (5): 598-605.
Sowmya C. SN, & Venkatarathnamma P. N. Adherence to Antiepileptic Therapy in Adults. J Neurosci Rural Pract. 2017 8 (3): 417–20.
Hovinga CA AM, Manjunath R, Wheless JW, Phelps SJ, Sheth RD et al Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: Survey of patients with epilepsy and physicians. E & B. 2008; 13 (2): 316-22.
Gabr WM SM. Adherence to medication among outpatient adolescents with epilepsy. Saudi Pharm J. 2015; 23: 33-40.
Sebastian J AR, Keshava BS Harsha S. Assessment of antiepileptic drugs usage in a South Indian tertiary care teaching hospital. NA. 2013; 18 (2): 159-65.
Ranjana G. KC, GRK Sarma. An evaluation of factors affecting adherence to antiepileptic drugs in patients with epilepsy: a cross-sectional study. Singapore Med J. 2017; 58 (2): 98-102.
Yohannes T. H. ATD. Adherence to Treatment and Factors Affecting Adherence of Epileptic Patients at Yirgalem General Hospital, Southern Ethiopia: A Prospective Cross-Sectional Study. PLoS ONE 2016; 11 (9).
W A. Health beyond politics. World Health Organization Eastern Mediterranean Regional Office. Lebanon: Ministry of Public Health. 2009.
Guo Y DX, Lu RY, Shen CH, Ding Y, Wang S, et al. Depression and anxiety are associated with reduced antiepileptic drug adherence in Chinese patients. Epilepsy Behav. 2015; 50: 91-5.
Smithson WH HD, Buelow JM, Allgar V, Dickson J. Adherence to medicines and self-management of epilepsy: A community-based study. Epilepsy Behav. 2013; 26: 109-13.
Ellis CJ BE, Gamble GJ, et al. Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? J Psychosom Res. 2009; 67: 11-5.
Johnbull O, Farounb, B., Adeleye, A., Uche, A. Evaluation of factors influencing medication adherence in patients with epilepsy in rural communities of Kaduna State, Nigeria. Neurosc Med. 2011; 2 (4): 299-305.