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Factors Associated With Antiseizure Medication Adherence in Patients With Epilepsy: A Systematic Review
Gülcan Bahçecioğlu Turan1, Mizgin Demir1
1Nursing Department, Faculty of Health Sciences, Fırat University, Elazığ, Türkiye.
Brain and Behavior
|June 15, 2026
Summary
Adherence to antiseizure medication (ASM) in epilepsy is moderate, hindered by forgetfulness, complex regimens, side effects, and psychosocial/economic factors. Multidimensional interventions are crucial for improving patient outcomes and quality of life.
Area of Science:
- Neurology
- Pharmacology
- Public Health
Background:
- Epilepsy is a common chronic neurological disorder requiring consistent antiseizure medication (ASM) therapy for effective seizure control and improved quality of life.
- Poor ASM adherence significantly increases morbidity, mortality, and healthcare burden in epilepsy patients.
- Understanding factors influencing ASM adherence is critical for developing targeted interventions.
Purpose of the Study:
- To systematically review and synthesize evidence on factors associated with antiseizure medication (ASM) adherence among patients with epilepsy.
- To examine these factors across diverse sociocultural and clinical settings globally.
- To identify key barriers and facilitators influencing ASM adherence in epilepsy management.
Main Methods:
- Systematic literature searches were conducted across major scientific databases (PubMed, Scopus, Web of Science, Google Scholar).
- PRISMA 2020 guidelines were followed for study identification and screening, with 5736 records initially identified.
- Forty-one quantitative studies, critically appraised using Joanna Briggs Institute checklists, were included in the final synthesis.
Main Results:
- Moderate levels of ASM adherence were reported across most included studies.
- Key barriers to adherence included forgetfulness, complex medication regimens (polytherapy), and adverse drug effects.
- Psychosocial factors (depression, anxiety, stigma) and socioeconomic barriers (low income, high medication costs) significantly impacted adherence, particularly in low- and middle-income countries.
Conclusions:
- Antiseizure medication adherence in epilepsy is influenced by a complex interplay of biological, psychosocial, cultural, and economic factors.
- Major barriers encompass forgetfulness, treatment complexity, side effects, mental health issues, stigma, and financial constraints.
- Multidimensional interventions, including patient education, psychosocial support, simplified regimens, and policy changes, are essential for enhancing adherence and improving epilepsy care.
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