title: Impact of health education on drug adherence and self-care in people with epilepsy with low education.
abstract: OBJECTIVE
  This study was conducted to observe the effect of a structured educational program on drug adherence and self-care management in people with epilepsy in a developing country.
  
  
  METHODS
  A total of 180 consecutive people with epilepsy were enrolled from the epilepsy clinic of a tertiary care hospital in North India. Out of these, 90 were randomized to the epilepsy health education group and received the educational program and 90 were in the control group and received the standard of care but did not receive any structured educational program. The modified Morisky Medication Adherence Scale (MMAS) and Epilepsy Self-Efficacy Scale (ESES) were administered to assess drug adherence and self-care, respectively, on the day of enrollment. The patients enrolled in the epilepsy health education group received 4 sessions of the structured educational program. The MMAS and ESES questionnaires were again administered to both groups after 6months.
  
  
  METHODS
  Continuous and categorical variables were compared between control and epilepsy health education groups using a chi-square test, with p value less than 0.05 considered significant. A comparison between pretest and posttest MMAS scores and ESES scores was done using a paired t-test.
  
  
  RESULTS
  In the epilepsy health education group, the pretest mean MMAS score was 6.58 whereas the posttest mean MMAS score was 7.53; the difference was significant (p=0.001). The mean MMAS scores for the control group's pretest and posttest were 6.46 and 6.58, respectively, which were not significantly different (p=0.224). On comparing the ESES scores at the beginning of the study and after 6months, there was no significant change in both groups.
  
  
  CONCLUSIONS
  The present study proves the efficacy of a structured educational program in improving drug adherence in a cohort of people with epilepsy with low educational background.
authors.affiliation: All India Institute of Medical Sciences, Delhi, India.
authors.forename: Deepa
authors.initials: D
authors.lastname: Dash
authors.affiliation: All India Institute of Medical Sciences, Delhi, India.
authors.forename: Teenu Mary
authors.initials: TM
authors.lastname: Sebastian
authors.affiliation: All India Institute of Medical Sciences, Delhi, India.
authors.forename: Meena
authors.initials: M
authors.lastname: Aggarwal
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, Delhi, India. Electronic address: manjari.tripathi1@gmail.com.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004522:Educational Status; D004827:Epilepsy / Q000188:drug therapy* / Q000534:rehabilitation; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000706:statistics & numerical data*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000927:Anticonvulsants
keywords: Adherence; Education; Epilepsy; Self-care; Self-management