Medication Nonadherence in Children with Epilepsy Attending Outpatient Clinics in Under-Resourced Community

Abstract

Nonadherence to epilepsy medications can interfere with treatment and may adversely affect clinical outcomes, although few studies have examined this relationship in childhood epilepsy in under-resource settings. Our aim was to determine the rate of anti-epileptic drugs (AEDs) nonadherence in families caring for a child or adolescent with epilepsy, and to describe some associated factors in under-resource settings. A cross-sectional snapshot descriptive study design was used. Interviewer-administered structured questionnaires were completed in a sample of 120 children with epilepsy on AEDs for at least 1 month prior to the registration attending outpatient visits at free pediatric neurology camps in under-resource settings. Information was obtained about adherence to antiepileptic regimens as well as factors influencing adherence to AED regimens. Drug adherence was suboptimal in 70 (58%) and satisfactory in 50 (42%) of the patients according to self or parental report. Age of the patient and caregiver did not significantly influence the drug compliance but adherence intention, and AED prescription patterns, adverse effects, availability of AEDs, seizure control, treating physician's counseling, financial constraints, and parental/caregiver's education were more significantly associated with drug nonadherence in these communities. The assessment of medication adherence in patient-oriented epilepsy treatment programs for patients with childhood epilepsy should be a routine part of the management process to promote self-management and are essential to maximize the treatment outcome.