title: An evaluation of factors affecting adherence to antiepileptic drugs in patients with epilepsy: a cross-sectional study.
abstract: BACKGROUND
  Adherence to antiepileptic drug (AED) therapy is important for controlling seizures in patients with epilepsy (PWE). It is vital to identify the factors influencing adherence to AED therapy using validated tools. This study aimed to evaluate the pattern and extent of AED adherence among PWE and to identify the factors that influence adherence.
  
  
  METHODS
  This was a cross-sectional study involving PWE who had a confirmed diagnosis. Treatment adherence was assessed using the four-item Morisky Medication Adherence Scale. Univariate analysis with chi-square test was used to observe the association between different variables and AED adherence. Binary logistic regression analysis was used to identify the predictors of adherence.
  
  
  RESULTS
  451 PWE (mean age 27.3 ± 8.1 years) were enrolled in the study; 251 (55.7%) were male and 198 (43.9%) were from the lower socioeconomic class. 326 (72.3%) patients had high adherence to AED therapy, while 125 (27.7%) had low adherence. AED adherence was significantly associated with socioeconomic status (p = 0.043) and type of epilepsy (p = 0.033). However, no significant difference was observed between adherence and age, gender, marital status, epilepsy duration, number and type of AEDs, and occurrence of adverse drug reactions. Patients with focal epilepsy and those from the middle/lower-middle socioeconomic classes were less likely to be nonadherent. The primary reason for nonadherence was forgetfulness.
  
  
  CONCLUSIONS
  This study found that a majority of PWE have optimal rates of AED adherence and that forgetfulness is the primary reason for nonadherence among PWE.
authors.affiliation: Department of Pharmacology, St John's Medical College and Hospital, Bangalore, India.
authors.forename: Ranjana
authors.initials: R
authors.lastname: Gurumurthy
authors.affiliation: Department of Pharmacology, Sri Rajarajeshwari Medical College and Hospital, Bangalore, India.
authors.forename: Kulkarni
authors.initials: K
authors.lastname: Chanda
authors.affiliation: Department of Neurology, St John's Medical College and Hospital, Bangalore, India.
authors.forename: Grk
authors.initials: G
authors.lastname: Sarma
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D012044:Regression Analysis; D012640:Seizures / Q000188:drug therapy; D012923:Social Class; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Morisky Medication Adherence Scale; antiepileptic drugs; epilepsy; treatment adherence