Adherence to Antiepileptic Drugs and Influencing Factors among Persons with Epilepsy Attending an Epilepsy Clinic of a Tertiary Hospital in Bangladesh

Background: Epilepsy is one of the most prevalent and debilitating chronic
neurological illnesses. Treatment adherence is one of the determinants
of seizure control in persons with epilepsy (PWE). The purpose of this
study was to assess adherence to antiepileptic drugs (AEDs) and factors
associated with non-adherence in a sample of Bangladeshi PWE
attended to an Epilepsy Clinic of a tertiary hospital in Bangladesh.

Objective: The aim of study was to assess the extent of AED adherence and the
factors influencing AED adherence among PWE.

Methods: This analytic cross-sectional study was conducted in the Department of
Neurology at Rangpur Medical College Hospital, Rangpur, Bangladesh,
from July 2022 to June 2023. The patients were recruited from the
epilepsy clinic. Data on adherence to medication and related factors for
each patient were gathered using an interviewer administered structured
questionnaire. Adherence was defined as not missing a dose and
non-adherence is missing a dose or stopping treatment in the last month.

Results: Of a total of 225 patients studied, 63(28%) patients were non-adherent
with regards to AEDs. There were no demographic differences (based on
gender, age, residential location, education, marital status,
socioeconomic status, and seizure type) between adherent and
non-adherent patients. The primary reason for non-adherence was
forgetfulness or inability to buy drugs (66.6%), followed by a Lack of
understanding of the need for long-term medication (22.2%). PWE who
were on single AED were more likely to be adherent to AED than those
were on polytherapy number of AEDs and adherence (p=0.037).
Patients not-adherent to AEDs had a longer duration of illness [9.5
(4.0-17.0) years] (p<0.001). than the patient’s adherent to AEDs [median
(Interquartile rage) 5.0 (2-11) years]

Conclusions: About one-third of PWE needed to be more compliant with their
medication. If the treatment of PWE is restricted to monotherapy as far
as possible and they are educated about the duration of therapy and
possible adverse effects of AEDs, non-adherence may be reduced.