Antiepileptic Drug Adherence and Associated Factors Among Adult Epileptic Patients Attending Neurology Referral Clinic in Adama Hospital Medical College, Ethiopia

Abstract

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.