Background Epilepsy is a chronic condition characterized by unusual, frequent, excessive, and self-terminating neuronal firing. Adherence to medication is crucial to achieve the intended therapeutic outcome. However, not much research has been done on drug adherence in our context. Thus, the purpose of this study is to investigate the antiseizure medication prescribing pattern, medication adherence, and associated factors.

Methodology A cross-sectional, analytical research was done on randomly selected epileptic patients through interview and documentary analysis using a semi-structured interview schedule and the eight-item Morisky Medication Adherence Scale (MMAS-8). The clinical and demographic characteristics were described using descriptive statistics (median, interquartile range [IQR], frequency, and percentage). The Shapiro–Wilk and chi-squared tests were used to examine the factors influencing medication adherence and the relationships between research variables. The analysis was performed using SPSS version 16.

Result From a total of 104 patients, 77.3% were males, the median age was 29 years (IQR: 16), the majority (42.3%) had higher secondary education, 15.4% had secondary education and 5.8% were illiterate, 25% were job holders, 26% were laborers, 41.3% were from province 3, and 16.3% were from province 4. Two-thirds (63.5%) of the patients were highly adherent to antiseizure medication and 54.8% were seizure free for more than 2 years.

The most common type of epilepsy diagnosed was generalized epilepsy (54.8%). Seizures were usually treated with monotherapy (65.4%), with sodium valproate being the most often used single antiseizure medicine (26.8%), followed by carbamazepine (16.3%) and levetiracetam (15.4%). Additionally, sodium valproate was the medication most frequently used in polytherapy for epilepsy. There was a strong association established between adherence and drug therapy type, age, adverse drug reaction, and seizure control. The study revealed that adherence was not significantly associated with factors such as gender, occupation, regional distribution, or type of epilepsy.

Conclusion Low adherence was observed in 36.5% of patients. As a significant association was observed between medication adherence and seizure control, health care providers should focus on improving medication adherence. Evaluation of adherence needs to be a regular component of managing epilepsy. Further patients who do not stick to their drug regimens should receive more attention and assistance. It will support better therapy results.

Prior to data collection, permission was obtained from UDM-NINAS and the Institutional Review Committee at the Central Institute of Science and Technology, affiliated to Pokhara University, Nepal approved the study (Ref no.: IRC-02–076/077). Participants received a written consent form outlining all the facts in both Nepali and English. For illiterate individuals, inform consent was obtained by thumbprint after verbally giving the content provided in the form. They were informed that participation would be voluntary, and sufficient time was given to read and understand it. Any types of economic and other benefits were not provided and any influence was not used to collect the data from the patients.

Research was performed in accordance with the Declaration of Helsinki and was approved by the ethics committee Institutional Review Committee at Central Institute of Science and Technology (IRC-CiST), affiliated to Pokhara University, Nepal (Ref: IRC-02–076/077). All the patients gave written consent to participate in the study.

S.T., P.P., and S.B.K. developed the study concept; S.T., P.P., and S.P. conducted the data mining and analysis; and P.P. and S.P. wrote the manuscript, which was reviewed and edited by all the authors.

The dataset analyzed during the current study are available from the corresponding author on request.

Article published online:
07 October 2024

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