Self-reported medication adherence to antiepileptic drugs and treatment satisfaction among paediatric patients having epilepsy: A cross sectional study from the Indian subcontinent

Abstract

Introduction: Non adherence to antiepileptic drugs (AEDs) can vary the course of epilepsy. There is a dearth of data regarding adherence status among paediatric epilepsy patients. Objectives: To determine the level of AED adherence among paediatric patients having epilepsy and to assess the relationship between AED adherence and treatment satisfaction among paediatric epileptics. Method: A cross sectional study was conducted at a tertiary level referral hospital in northern India from July 2015 to June 2016 on children aged 2 to 13 years of age, diagnosed with epilepsy and treatment initiated with at least 1 AED for the past 6 months. Data collection was done using a questionnaire which was divided into three parts. The first part comprised demographical information about patients and their caregivers along with clinical details of epilepsy. The second part gathered information about medication adherence profile with the help of the Morisky Medication Adherence Scale-8 (MMAS-8). The third part gathered data on treatment satisfaction profile about these patients with the help of Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). The estimated sample size was at least 61 patients. Data was analysed using Graph Pad InStat 6.0. Ethical approval was obtained from the institutional ethics committee.   Results: A convenient sample of 112 patients with their respective immediate caregivers was enrolled in this study. The mean age of children was 9.82±2.17 years and male to female sex ratio was 1.24. Fifty (44.6%) patients had low adherence, 29 (25.9%) medium adherence and 33 (29.5%) high adherence to AEDs as per MMAS-8 questionnaire. Altogether 79 (70.5%) children were non adherent when dichotomised MMAS scores were considered. Age of children, duration of epilepsy, mean number of family members, frequency of drug ingestion by patient, employment status of caregiver were significantly associated with non-adherence in epileptic children. Children adhering to medication prescription had significantly higher satisfaction in the effectiveness, convenience and global satisfaction domains of TSQM. Conclusions: Twenty nine percent of epileptic children showed medication adherence to AEDs in the present study. Increasing age of children, increased duration of epilepsy, increasing mean number of family members, patients taking medications more than once per day and employed caregiver status were significantly associated with non-adherence in epileptic children. Satisfaction scores were higher in medication adherent children, particularly in the effectiveness, convenience and global satisfaction domains but not in the side effects domain. Sri Lanka Journal of Child Health , 2018; 47 (2): 129-136