A narrative review of antiseizure medication adherence in epilepsy: determinants to clinical implications

Achieving optimal seizure control without recurrence is a critical goal in epilepsy. When evaluating whether treatment is effective, medication adherence must be carefully considered but has traditionally been overlooked. In this study, we introduce commonly used definitions of medication adherence and examine adherence findings in epilepsy and other chronic diseases. Factors influencing adherence are analyzed according to three domains: the characteristics of the medication itself, patient-related factors, and environmental or socioeconomic influences. Considering not only the pharmacologic properties of antiseizure medications but also the roles of social and economic support in clinical practice may help reduce the risk of breakthrough seizures and early mortality in patients with epilepsy.