Challenges in Epilepsy Medication Adherence in Ethiopia

Taking medication as prescribed is very important for people with chronic health issues. When patients do not follow their medication schedule, it can lead to serious health problems. This is especially true for chronic illnesses that require long-term treatment. Epilepsy is one such condition that affects many people globally.

#What is Epilepsy?

Epilepsy is a common neurological condition that causes seizures. It affects around 50 million people around the world, with a large number living in developing countries. The treatment for epilepsy mainly involves taking antiepileptic drugs (AEDs). These medications are effective in reducing seizures in many adults. Despite this, a significant number of people with epilepsy do not receive the treatment they need, often due to cultural beliefs, poor healthcare resources, and not enough available medications.

#The Situation in Ethiopia

In Ethiopia, epilepsy is often misunderstood and may be wrongly seen as a mental illness. Because of this, many patients end up being treated by mental health professionals instead of neurologists. The most common AEDs prescribed include phenobarbitone, phenytoin, carbamazepine, and sodium valproate.

Adherence to AEDs is crucial, as it directly affects how well the medications work. In countries like the US and the UK, the rates of adherence are fairly high compared to some regions in Ethiopia. Studies have shown varying rates of adherence among patients with epilepsy in Ethiopia, with some areas reporting lower numbers, and others reporting higher. In places like India and Palestine, the adherence rates are significantly better.

#The Consequences of Non-adherence

When patients with epilepsy do not stick to their medication schedule, it can lead to severe outcomes. These include poor control of seizures, a higher chance of health complications, increased hospital stays, and a poorer quality of life. Non-adherence also brings a heavier financial burden on healthcare systems, impacting not just patients but their families as well.

In low and middle-income countries, including Ethiopia, there are many issues that make it hard for patients to access AEDs. Many people cannot find these medications in their local pharmacies, and even if they can, the prices may be too high for them to afford. In some studies, it was found that pharmacies in certain regions have inadequate stocks of AEDs.

#Research Purpose

This research aimed to understand how available and affordable AEDs are from the patients' viewpoint. By focusing on the patients' experiences, the goal was to see how these factors influence their ability to adhere to their medication. Though many studies focus on the healthcare system's perspective, this research wanted to highlight the patients' challenges.

#Study Design

The study took place in a hospital in Ethiopia over a period of a few months. The hospital caters to many patients with epilepsy and has a dedicated clinic for them. Participation in the study was based on adult patients actively using AEDs for their epilepsy treatment.

#Who Was Included?

Adult patients aged 18 and older, who had been on AEDs for at least three months, were included. Those with severe health conditions or who could not communicate were excluded from the study.

#How the Study Worked

A specific number of participants was chosen based on previous studies, allowing room for those who might not respond. Patients were interviewed to gather information about their background, medical history, social circumstances, and their experiences with AEDs. They answered questions about their access to medications and their medication adherence.

#Measuring Adherence

To assess how well patients were sticking to their AED regimen, a simple questionnaire was used. Patients answered three main questions about whether they had missed doses or forgotten to take their medicine. Based on their responses, their adherence was categorized as low, medium, or high.

#Ensuring Quality

To make sure the gathered information was accurate and reliable, the researchers trained healthcare professionals to conduct the interviews. The questionnaire was tested beforehand to address any issues, and daily checks ensured data quality throughout the process.

#Analyzing Data

Once the data was collected, it was organized and analyzed using specific software. The researchers looked for trends and connections between patient demographics, experiences with medication, and adherence rates.

#Key Findings

Out of the participants, a significant number struggled to stick to their AEDs. They reported that the lack of Availability of medications and forgetfulness were the main reasons for their non-adherence. The study found that a large portion of the patients viewed AEDs as either unavailable or unaffordable.

#Factors Influencing Adherence

Several factors played a role in whether patients stuck to their medication:

1. Education Level: Patients with higher education were more likely to adhere to their medication. Those who had completed secondary education or further were significantly more likely to follow their prescriptions compared to those with no formal education.

2. Availability of Medications: Patients who had access to AEDs reported higher adherence rates. When medications were readily available, patients were more likely to stick to their treatment plans.

3. Polytherapy vs. Monotherapy: Patients taking multiple AEDs had lower adherence rates compared to those on a single medication. The complexity of managing several medications can make it harder for patients to keep up.

4. Affordability: While the initial findings suggested that affordability played a role in adherence, this association did not hold when accounting for other factors.

#Comparison with Other Studies

The adherence rate found in this study was relatively moderate when compared to other research. Some studies in Ethiopia have shown similar rates, while others in different countries have indicated higher levels of adherence. The differences could stem from variations in study designs, participant circumstances, or the local healthcare environment.

#Common Barriers

Patients identified several key barriers to adherence, including:

• Unavailability of Medication: Many patients reported that they could not find their medications easily.
• Forgetfulness: Forgetting to take medication was common and contributed to non-adherence.
• Cost of Medication: The price of AEDs was a concern for many, making it difficult for them to maintain their treatment plan.

#Conclusion and Recommendations

In summary, just over half of the patients adhered to their prescribed AEDs in this study. The accessibility of these medications must improve to ensure better health outcomes for individuals with epilepsy. Addressing the issues of availability and affordability will be critical in helping patients stay on track with their treatment.