Risk of Seizures Associasted with Non-Adherence to Antiepileptic Drugs

Abstract

Introduction: Epilepsy is one of the most common neurological diseases worldwide. In Bangladesh, the prevalence of epilepsy in children was 8.2/1000 population. Among many factors, non-adherence to AEDs is an important modifiable factor for seizure control. This study aimed to assess the risk of seizures associated with non-adherence to antiepileptic drugs. Methods & Materials: This cross-sectional study was conducted at the Department of Pediatric Neurology and Development; National Institute of Neurosciences and Hospital (NINS&H), Dhaka, from January 2022 to December 2022. A total of 250 children were selected as study subjects by systematic random sampling without a sampling frame technique. After assessment by MMAS-8, children with epilepsy were categorized into two groups, AEDs adherent (n₁) and non-adherent group (n₂₎. Statistical significance and confidence interval were set at p<0.05 and 95% level respectively. Result: In this study among 250 children with epilepsy, 56.8% (n=142) children were found non-adherent to AEDs. There was a significant (p<0.05) association between drug non-adherence and higher maternal education as well as poor seizure control. Forgetfulness (p=0.00, OR=5.00), child’s refusal to take AEDs (p=0.00, OR=5.29), and long duration of treatment (p=0.017, OR=2.33) were found to increase the risk of non-adherence. Conclusion: Non-adherence to antiepileptic drugs (AEDs) significantly increases the risk of uncontrolled seizures, with key contributing factors including forgetfulness, child refusal to take medication, and long treatment duration. Higher maternal education and lower family income were also associated with higher non-adherence rates. Logistic regression analysis confirmed that forgetfulness and child refusal to take AEDs were the strongest independent predictors of non-adherence.