Barriers to Medication Adherence in People Living With Epilepsy

Area of Science:

• Neurology
• Public Health
• Pharmacology

Background:

• Epilepsy affects 3.4 million Americans, with one-third experiencing drug-resistant epilepsy.
• Antiseizure medications (ASMs) are primary treatment, but nonadherence is common, leading to preventable seizures.
• Recognizing adherence challenges is crucial for effective interventions and improved patient outcomes.

Purpose of the Study:

• To examine the relationship between barriers to antiseizure medication (ASM) adherence and seizure control in people with epilepsy (PWE).
• To explore associations between adherence barriers, seizure control, and demographic variables.

Main Methods:

• A cross-sectional study analyzed data from 4,917 individuals across 8 US epilepsy clinics (2020-2023).
• Logistic regression was used to assess the link between reported adherence barriers and seizure control.
• Demographic variables (sex, race, ethnicity) were explored for potential associations.

Main Results:

• 18.4% of individuals reported adherence barriers; 37.7% achieved seizure control.
• Top barriers included forgetting ASMs (48.2%), side effects (29.2%), and perceived lack of efficacy (21.3%).
• Reported adherence barriers were associated with significantly lower odds of seizure control (OR 0.6, 95% CI 0.5-0.7).

Conclusions:

• Significant barriers to ASM adherence and inadequate seizure control exist among adult PWE.
• Standardized screening for adherence barriers and tailored behavioral interventions are recommended in clinical practice.
• Personalized care strategies addressing adherence barriers can enhance seizure control and patient outcomes.