Medication Belief and Adherence among Patients with Epilepsy

Abstract

Background. Medication adherence and belief are crucial to achieving the desired goal of therapy in epileptic patients. However, there is a lack of study regarding medication adherence and belief in our setting. Therefore, the purpose of this study was to investigate medication adherence and belief and associated factors among ambulatory patients with epilepsy. Method. A cross-sectional study was conducted on randomly selected epileptic patients at the neurologic clinic of Ayder Comprehensive Specialized Hospital, Ethiopia. Medication adherence and belief were assessed using self-reported questionnaires which were developed based on the review of different literatures. Data were analyzed using binary logistic regression analysis. Result. We included a total of 292 patients. Almost two-thirds (65.4%) of the patients were nonadherent to their medications. The most common cause of nonadherence was forgetfulness (48.7%) followed by inability to get medicine (28.8) and safety concern (23.5%). The majority (78.4%) of the patients had high medication necessity belief while 44.1% had high concern belief about the potential adverse effect of their medications. Overall, 39.4% of the patients had a negative belief toward their medications. Comorbidity (AOR: 3.51, 95% CI: 1.20-10.31), seizure encounter within the last 3 months (AOR: 5.45, 95% CI: 2.48-12.00), low medication necessity belief (AOR: 3.38, 95% CI: 1.14-10.00), high medication concern belief (AOR: 4.23, 95% CI: 2.07-8.63), and negative medication belief (AOR: 4.17, 95% CI: 1.74-10.02) were predictors of medication nonadherence. Conclusion. Majority of the epileptic patients were nonadherent to their medications, and more than one-third of the patients had a negative medication belief. Low medication necessity belief, high medication concern belief, negative medication belief, comorbidity, and seizure encounter were predictors of medication nonadherence. Therefore, healthcare providers should design educational programs to enhance the patients’ believe about their medication in order to improve medication adherence and overall treatment outcome.

A systematic review and meta-analysis of anti-epileptic medication non-adherence among people with epilepsy in Ethiopia

“…Similarly, adults epileptic patients in Ethiopia who had current substance use or drug abuse behaviour were 2.01 times more likely to be anti-epileptic medication non-adherent as compared to adults who had not current substance use or drug abuse habit. This might be due to the fact that psycho-active substances have a direct brain effect that enables individuals to be forgetful or negligence towards their anti-epileptic medication as they are often preoccupied by searching of mechanisms to satisfy their urgent needs of substance use [46].…”

“…There were fourteen primary studies included in our systematic review and meta-analysis. These studies were conducted across different regions of Ethiopia (two primary articles from Tigray [45,46], six at Amhara [47][48][49][50][51][52] two Oromia [53,54], two South Nation, Nationality and People (SNNPR) [22,55] and other two from Addis Ababa [40,56]. The sample size of primary studies included in this review was considerably variable ranging 88 to 450 participants.…”

How do pediatric patients perceive adverse drug events of anticonvulsant drugs? A survey

“…There are several factors that can influence adherence in pediatric epilepsy therapy [19,26]. In patients with epilepsy, safety concerns are a common reason for non-adherence to anticonvulsant medication [21]. A poor adherence can worsen the epilepsy [6] with an increased epilepsy-related mortality.…”

Examining and adapting the information–motivation–behavioural skills model of medication adherence among community-dwelling older patients with multimorbidity: protocol for a cross-sectional study

“…The harm of medication is patients’ beliefs about how harmful medications are and the overuse of medication is patients’ beliefs about how medications are overused by doctors. Studies have demonstrated that patients perceiving higher necessity of medication and lower concerns about medication treatments are more likely to have better medication adherence among patients with various chronic conditions 23–25. Patients who believe that medications in general are harmful substances, which are overused by doctors are more likely to report lower medication adherence 23…”

“…The impact of chronic conditions on patients’ functioning can further impair their ability to adhere to medications 43. Longer duration of chronic diseases, a great number of co-existing conditions and higher severity of diseases have been found to be associated with lower medication adherence 25 44…”