An Evaluation of Factors Affecting Nonadherence to Antiepileptic Drugs in Epilepsy Patients Attending Tertiary Care Hospital: A Cross-Sectional Study

Abstract

Nonadherence to antiepileptic drugs is a major barrier to effective seizure control. This present study aimed to determine the rate of nonadherence using the Morisky Medication Adherence Scale-8 scale, identify factors influencing non-adherence, and to evaluate its relationship with quality of life (QOL) among epileptic patients using the World Health Organization QOL-BREF questionnaire. After approval from the Institutional Ethics Committee and written informed consent, a cross-sectional and an observational study was conducted among epileptic patients, attending the outpatient and inpatient Department of Neurology in a tertiary care hospital. Out of 109 patients interviewed, 54.13% were females, with focal type of epilepsy being more common (55%). Most patients had a duration of epilepsy <10 years with no family history. Nonadherence (18.4%) to antiepileptic therapy (AET) was mainly due to perceived symptom control, and it was more among females and less educated patients. This was significantly associated with higher seizure frequency, longer disease duration, and the occurrence of adverse drug reactions with AET. Factors such as education, comorbidities, and seizure frequency have influenced lower QOL in physical, psychological, and environmental domains. This study found that gender, education level, seizure frequency, and occurrence of adverse drug reactions significantly affect patients’ nonadherence to AET. QoL was influenced by education status, comorbidities, and seizure frequency. Hence, education plays an essential role in reducing stigma, enhancing disease awareness, and promoting treatment adherence, thereby improving QOL. Thus, healthcare professionals should provide counselling and conduct awareness programs highlighting the consequences of non-adherence.