Prevalence and Predictors of Medication Non-Adherence Among Patients with Epilepsy in Maiduguri

Introduction: Despite the fact that pharmacotherapeutic intervention with anti-epileptic drugs (AEDS) remains the cornerstone in the treatment of Seizure Disorders, non-adherence to the medications constitutes a huge impediment to better clinical and prognostic outcomes, especially in low- and middle-income countries (LMICs). Aim: This study assessed the prevalence, as well as the socio-demographic, and clinical predictors of non-adherence to AEDs in Federal Neuropsychiatric Hospital (FNPH), Maiduguri, North-East, Nigeria. Method: It was a cross-sectional descriptive study in which 378 patients with epilepsy (PWEs) were randomly recruited and interviewed at the Epilepsy Clinic of FNPH. Data were collected using socio-demographic and clinical proformas designed by the authors, and non-adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS). Results: The prevalence of non-adherence to AEDs was 35.2% and no sociodemographic variable had statistically significant relationship with non-adherence. The independent clinical predictors associated with AED-nonadherence were: costs of medications (OR=9.776, 95% C.I = 5.985-15.771, P<0.001), polytherapy (OR=5.125, C.I= 2.730- 9.622, P<0.001), multiple dosing frequency (OR= 2.991, C.I= 2.027-4.413, P<0.001), presence of side effects (OR= 17.401, 95% C.I = 8.966-33.733, P<0.001), and comorbid conditions (OR=4.693, 95% C.I=2.240-9.830, P<0.001). Conclusion: Based on this study, over one third of patients with Epilepsy were found to be non-adherent to their medications and certain clinical predictors were associated with medication non-adherence.