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The effect of educational interventions on drug adherence in children with epilepsy and parents: Systematic review
Seçil Taylan1, Fatma Dilek Turan2, İlknur Özkan3
1Department of Surgical Nursing, Faculty of Kumluca Health Sciences, Akdeniz University, Antalya, Turkey.
Background:
Adherence to antiepileptic drugs (AEDs) is essential for achieving seizure control in children with epilepsy, yet adherence rates remain suboptimal, increasing the risk of preventable complications. This systematic review and meta-analysis synthesizes evidence from randomized controlled trials evaluating educational interventions designed to improve AED adherence in pediatric epilepsy.
Methods:
A comprehensive search was conducted across ten databases (CINAHL Complete, Cochrane CENTRAL, ScienceDirect, Web of Science, SpringerLink, PubMed, Ovid, ProQuest, Scopus, TR Index). Methodological quality was assessed using the Cochrane Risk of Bias tool (RoB 2). Heterogeneity was evaluated with Chi-square and I2 statistics, and publication bias with funnel plots, Egger's regression, and Begg-Mazumdar tests. Effect sizes were pooled using Hedges' g with 95% CIs. The protocol was prospectively registered in PROSPERO (CRD420251128572).
Results:
Eight randomized controlled trials met inclusion criteria. The pooled analysis showed a significant moderate improvement in adherence among intervention groups (Hedges' g = 0.490, p < 0.001). Subgroup analyses demonstrated greater effects for pharmacist-led interventions, family-centered approaches involving all family, and short-term follow-up periods (1-2 months).
Conclusion:
Educational interventions significantly improve AED adherence in children with epilepsy, with the strongest early-phase benefits observed in family-centered and pharmacist led models.
Implications For Practice:
Given the central role of nurses in epilepsy management, incorporating multidimensional, family-focused educational strategies and structured follow up into routine nursing care may help sustain adherence and optimize clinical outcomes.
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