Prevalence and factors associated with non-adherence to anti-epileptic drugs among epileptic individuals attending at Butabika National Referral Hospital, Uganda

Abstract

Background: Epilepsy, a neurological condition affects people of all ages around the world and was ranked the second leading contributor of global burden of disease responsible for 0.5% of the overall disease burden. Over 50 million people worldwide are affected majority in poor countries. About 70% of people with epilepsy respond to antiepileptic drugs treatment but non-adherence compromises treatment outcomes. Objective: Assessing prevalence of non-adherence to antiepileptic drugs and associated factors among people with epilepsy at Butabika hospital out-patients clinic. Methods: A cross-sectional study design was used. Structured questionnaires were administered to 124 respondents between July and August 2013 to individuals who were on antiepileptic drugs treatment for at least three months. Data analysis was done using STATA V12. The prevalence of non-adherence was determined based on patients who reported missing 85% of their prescribed drugs 30 days prior to the interview. The odds ratios and their 95% CI were used to assess association of independent variables with non-adherent status. Results: The prevalence of non-adherence was 35.5% (95% CI 27 - 44). The factors associated with non-adherence was inadequate information on medication (OR = 9.649, 95% CI: 2.23 – 41.69) (P-value = 0.002) while taking medication on time was a protective factor (OR=0.081, 95% CI: 0.022 – 0.29) (P-value >0.001). The AEDs type utilised, transport costs to health facility and home district were noted to be confounders. Conclusion: The study revealed a high prevalence of non-adherence with more than one in three non-adherents. This impacts directly on epilepsy treatment outcomes and overall patient quality of life. Efforts to minimise non-adherence could target associated factors, mainly adequate patient education. Patient education on medication is recommended to improve antiepileptic medication adherence.