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Published on: October 2, 2014
Perceived stigma and adherence in epilepsy: evidence for a link and mediating processes
Marie Chesaniuk1, Hyunmi Choi1, Paul Wicks2
1Columbia University, USA.
Objective:
This study tested whether perceived epilepsy-related stigma is associated with adherence in people living with epilepsy and if information, motivation, and behavioral skills are potential pathways underlying the stigma-adherence link.
Methods:
We surveyed persons living with epilepsy between the ages of 18 and 65 (N = 140) using an online questionnaire to assess medication adherence and perceived epilepsy-related stigma. In addition, participants reported their level of information, motivation, and behavioral skills.
Results:
Higher perceived epilepsy-related stigma was associated with lower medication adherence (r = -0.18, p < .05). Higher perceived stigma was associated with lower levels of information (r = -0.28, p < .05), motivation (r = -0.55, p < .05), and behavioral skills (r = -0.41, p < .05), and the link between stigma and adherence was fully explained by information, motivation, and behavioral skills, i.e., the effect of stigma on adherence was fully mediated (c = -0.18, p < .05 reduced to c' = 0.06, p = .48).
Conclusion:
Perceived epilepsy-related stigma is problematic for maintaining the prescribed medication regimen in people living with epilepsy. The information-motivation-behavioral skills model is a useful framework for understanding the pathways linking perceived stigma and adherence in this population.
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