Unraveling Antiseizure Medication Adherence in Paediatric Epilepsy: Implications for Clinical Practice and Patient Care

Anchu Anna Cherian; Mini Sreedharan; Priya Sreenivasan; Mary Iype; Shahanaz Ahamed; Azmi Habeeb; Reshmi Raveendran; Roshni R Lal

doi:10.1016/j.yebeh.2024.110089

Unraveling Antiseizure Medication Adherence in Paediatric Epilepsy: Implications for Clinical Practice and Patient Care

Epilepsy Behav. 2024 Oct 29:161:110089. doi: 10.1016/j.yebeh.2024.110089. Online ahead of print.

Authors

Anchu Anna Cherian¹, Mini Sreedharan², Priya Sreenivasan³, Mary Iype¹, Shahanaz Ahamed¹, Azmi Habeeb¹, Reshmi Raveendran¹, Roshni R Lal¹

Affiliations

¹ Department of Pediatric Neurology, Government Medical College Thiruvananthapuram, India.
² Department of Pediatric Neurology, Government Medical College Thiruvananthapuram, India. Electronic address: drmini70@yahoo.com.
³ Department of Pediatrics, Government Medical College Thiruvananthapuram, India.

PMID: 39476705
DOI: 10.1016/j.yebeh.2024.110089

Abstract

Objective: Non adherence to antiseizure medications (ASM) is a common and modifiable risk factor for poor control of epilepsy and contributes to increased hospitalizations, bias in assessing the effectiveness of therapy and inaccurate clinical decision making.The aim of the study was to estimate proportion of nonadherence to antiseizure medications among children with epilepsy and to identify clinical and demographic factors that contribute to antiseizure medication non adherence.

Methods: Consecutive subjects ≤ 18 years with epilepsy, on antiseizure medications for atleast three months, attending Pediatric Neurology OPD, Government Medical College Thiruvananthapuram, Kerala, India were included in the study. Self reported adherence to antiseizure medications was measured using Medication Adherence Report Scale questionnaire. Perceptions towards medications were assessed using Beliefs about Medicines Questionnaire Clinicodemographic factors and medication beliefs were analysed to examine their association with non-adherence in the participating children.

Results: The rate of non-adherence in children with epilepsy was 32%. 68% of the study population had high necessity beliefs and 60% showed low concern beliefs, which indicated overall positive perception towards medications. Univariate analysis showed that the following were significantly associated with ASM non adherence: ASM side effects (OR:3.01; 95% CI:1.52-5.92; p < 0.001) and ASM Concerns (OR: 0.84; 95% CI: 0.77-0.92; p 0.0003) and Necessity-Concern Differential Score (OR: 1.19; 95% CI: 1.10-1.29; p 0.0001). Other clinic-demographic variables did not exhibit a significant association with adherence. Multivariate analysis showed that both ASM side effects and ASM beliefs, represented by NCD score remained significant.

Conclusion: Perceptions towards medications have an important and potentially modifiable association with medication non adherence. Interventions to improve adherence should be tailored to each patient, including measures to address the specific beliefs of the patient and the family, along with practical barriers such as side effects of medications.

Keywords: Adherence; Antiseizure medications(ASM); Beliefs about Medications (BMQ); Medication Adherence Report Scale (MARS); Necessity Concerns Framework.