Evaluation of Factors Influencing Medication Adherence in Patients with Epilepsy in Rural Communities of Kaduna State, Nigeria

摘要

Background and Objective: Adherence to medication is the backbone to effectiveness of a therapy. In the absence of a definitive curative therapy, antiepileptic therapy is a key intervention aimed at prolonging and improving the quality of life of patients with epilepsy (PWE) who suffer from a disease known for its stigmatization with many cultural misconceptions. The aim of the study is to assess the level of, and factors influencing adherence to antiepileptic therapy among patients in rural communities attending the outpatient clinics in Ahmadu Bello University Teaching Hospital, Zaria and Jicon Hospital, Kaduna, Northern Nigeria. Materials and Methodology: A cross-sectional descriptive study design was used. Interviewer-administered, structured questionnaires were administered to a sample of 272 PWE attending Ahmadu Bello University Teaching Hospital/Jicon Hospital Kaduna, who had been on antiepileptic drugs (AEDs) for at least one year. Systematic random sampling technique was used to select the patients. Information was obtained on their knowledge of epilepsy and adherence to antiepileptic therapy regimen as well as factors influencing adherence to AED regimen. Results: The level of knowledge of epilepsy based on signs and symptoms was high as 57.8% and 25.9% of the PWE had excellent and good knowledge respectively. Also, most of the PWE (78.6%) had adequate knowledge of antiepileptic therapy, however only 32.6% of the patients were adherent to treatment. There was a significant association between knowledge of AED therapy and adherence to therapy (p = 0.00385) but there was no association between age (p = 0.067), sex (p = 0.182) educational status (p = 0.688), income (p = 0.519) religion (p = 0.69), place of residence (p = 0.157) with AED adherence. The reasons for non-adherence included forgetfulness, drug-induced fatigue and being away from home. Conclusion: This study showed that patients with epilepsy had adequate knowledge of epilepsy and its treatment. Medication adherence was demonstrated to be low due to forgetfulness, fatigue and being away from home. We therefore recommend adherence counseling in the clinic and health educational interventions to improve adherence in our rural communities. Further exploration of the relationship between clinical outcomes and other non-drug self-management strategies is needed.