The prevalence and major determinants of non-compliance with anti-seizure medication  among children

Ladan Afsharkhas; Shabnam Zamani; Azita Tavasoli; Babak Zamani; Atefeh Talebi

doi:10.18502/cjn.v21i1.9358

Ladan Afsharkhas Department of Pediatric Neurology, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
Shabnam Zamani Department of Pediatric Neurology, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
Azita Tavasoli Department of Pediatric Neurology, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
Babak Zamani Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Atefeh Talebi Colorectal Research Center, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cjn.v21i1.9358

Keywords: Epilepsy; Seizures; Drug Compliance; Anticonvulsants; Child

Abstract

Background: A wide range of adherence to the use of anti-seizure medications has been reported among children with the disease, and accordingly, various factors on the degree of adherence to the drug have been reported. But in our society, there is no clear picture of drug adherence and related factors among children with seizures. We evaluated the frequency of adherence to anti-seizure medication as well as related factors.

Methods: This cross-sectional study was conducted on 120 children with epilepsy who referred to Ali Asghar Hospital in Tehran, Iran, during 2019 and 2020. Along with demographic characteristics, adherence to antiepileptic medications was assessed by the Modified Morisky Scale (MMS).

Results: The overall frequency of adherence to anti-seizure medications among children was reported to be about 41.7%. Among all baseline characteristics, much higher adherence was revealed in patients with educated parents. The rate of drug adherence in children with a history of perinatal morbidities was much lower than in other patients. The type of seizure could also affect the rate of drug adherence as the highest and the lowest adherence was found concerning focal impaired awareness seizure (57.1%) and atonic seizures (11.1%) indicating a significant difference (P = 0.022). The most common causes of non-adherence to treatment were expressing inability to treat the patient (23.0%), parents’ forgetfulness to give medicine to the child (18.3%), and not taking medication when traveling or leaving home (16.7%).

Conclusion: The lower level of education of the parents, type of seizure, as well as the presence of underlying perinatal morbidity in the child can predict non-compliance with anticonvulsant medication regimens among affected children.