Evaluation of Factors Influencing Medication Adherence in Patients with Epilepsy in Rural Communities of Kaduna State, Nigeria

Abstract

Background and Objective: Adherence to medication is the backbone to effectiveness of a therapy. In the absence of a definitive curative therapy, antiepileptic therapy is a key intervention aimed at prolonging and improving the quality of life of patients with epilepsy (PWE) who suffer from a disease known for its stigmatization with many cultural misconceptions. The aim of the study is to assess the level of, and factors influencing adherence to antiepileptic therapy among patients in rural communities attending the outpatient clinics in Ahmadu Bello University Teaching Hospital, Zaria and Jicon Hospital, Kaduna, Northern Nigeria. Materials and Methodology: A cross-sectional descriptive study design was used. Interviewer-administered, structured questionnaires were administered to a sample of 272 PWE attending Ahmadu Bello University Teaching Hospital/Jicon Hospital Kaduna, who had been on antiepileptic drugs (AEDs) for at least one year. Systematic random sampling technique was used to select the patients. Information was obtained on their knowledge of epilepsy and adherence to antiepileptic therapy regimen as well as factors influencing adherence to AED regimen. Results: The level of knowledge of epilepsy based on signs and symptoms was high as 57.8% and 25.9% of the PWE had excellent and good knowledge respectively. Also, most of the PWE (78.6%) had adequate knowledge of antiepileptic therapy, however only 32.6% of the patients were adherent to treatment. There was a significant association between knowledge of AED therapy and adherence to therapy (p = 0.00385) but there was no association between age (p = 0.067), sex (p = 0.182) educational status (p = 0.688), income (p = 0.519) religion (p = 0.69), place of residence (p = 0.157) with AED adherence. The reasons for non-adherence included forgetfulness, drug-induced fatigue and being away from home. Conclusion: This study showed that patients with epilepsy had adequate knowledge of epilepsy and its treatment. Medication adherence was demonstrated to be low due to forgetfulness, fatigue and being away from home. We therefore recommend adherence counseling in the clinic and health educational interventions to improve adherence in our rural communities. Further exploration of the relationship between clinical outcomes and other non-drug self-management strategies is needed

An evaluation of factors affecting adherence to antiepileptic drugs in patients with epilepsy: a cross-sectional study

“…gender and age) between AED-adherent and AED-nonadherent patients. A study by Johnbull et al (15) reported a similar observation, in that gender did not affect the adherence rate in their study.…”

“…This finding is in accordance with those of studies conducted by Liu et al (13) and Paschal et al, (24) who reported that the primary reason for nonadherence in their study cohort was forgetfulness (69.6% and 32.5%, respectively). Johnbull et al (15) observed that forgetfulness was the reason for nonadherence in only 40.7% of their study cohort.…”

A Prospective Study on Impact of Patient Counselling on Quality of Life and Medication Adherence in Epileptic Patients

“…The main therapy related factors in our study include complexity of medication and problems related to therapy like sedation, weight gain, anger, etc. This result was in agreement with Johnbull et al who reported that forgetfulness and drug induced fatigue were the major reasons for poor adherence [6].…”

“…Quality of life (QOL) is a subjective concept based on the subject's perspective and experiences and involves physical, psychological, social and cultural components, all of which contributes to patient's adjustment to his condition and impacts perception in his life [4,5]. The frequency and seizure severity, adverse effects of antiepileptic drugs (AEDs), seizure worry, mood status, physical, cognitive, and psychosocial limitations including dependence of caregivers are determinant aspects frequently assessed by QOL inventories [6]. Medication adherence is the backbone of antiepileptic therapy.…”

Antiepileptic Drug Nonadherence and Its Predictors among People with Epilepsy

“…The magnitude of antiepileptic drug nonadherence is ranged from 26% in USA to 67% in Nigeria [7, 8]. As a study done in the North Carolina indicated, the prevalence of AEDs nonadherence was 39% and it was higher (43%) in elderly accompanied with increased likelihood hospitalization [9].…”