Abstracts

Rationale: This study looked at the frequency of and risk factors for anti-seizure medication (ASM) non-adherence among adult Saudi patients with epilepsy.

Methods: Patients with epilepsy were the subjects of a cross-sectional, single-center study at King Fahad Medical City, Riyadh, Saudi Arabia using data retrieved from medical records, from May 2023 to December 2023. Enrolled participants completed surveys containing self-reports on how frequently ASM dosages had been missed in the previous year. A structured and validated Morisky Medication Adherence Scale (MMAS-8) questionnaire was translated into Arabic and used to assess medication adherence after a license agreement from an appropriate authority. Cumulative scores less than 6 were considered low adherence, scores between 6 and 8 were considered medium adherence, and scores of 8 were considered strong adherence. A score of less than 6 is deemed non-adherent, whereas a score of more than 6 to 8, is considered adherent. To identify risk variables for non-adherence, a multivariate logistic regression model was utilized, and demographic factors, clinical factors, and potential barriers were correlated with the adherence status.

Results: Among 414 epilepsy patients with a median age of 28 years (IQR 22-34), Thirty-one of respondents (n = 131) were non adherent to antiseizure treatment. While sixty-four of respondents (n= 283) were adherent (figure 1). The multivariate analysis identified significant predictive factors for non-adherence. Higher levels of education and patients with later age at epilepsy diagnosis were significantly associated with adherence to ASM (p = 0.010 and p = 0.037 respectively). Suboptimal adherence was associated with forgetfulness (p = < 0.001), lack of hope (p = 0.008) perceived epilepsy-related stigma (p = < 0.001), medication refill failure (p = 0.001), and polytherapy (p = 0.053) (table 1).


Conclusions: Non-compliance to ASMs was found in one-third of the patients and should be regarded as an important cause of epilepsy treatment failure. Lower education, younger age at epilepsy diagnosis, polypharmcy, refill difficulties, hopelessness, absentmindedness, and feeling stigmatized, were associated with increased chances of being non-adherent. Determining modifiable risk factors can help target therapeutic and behavioral quality improvement efforts for those at high risk of treatment non-adherence.

Funding: None