Factors Related to Medication Adherence in Adolescents with Epilepsy

Main Article Content

Ketsuda Kempka
Autchareeya Patoomwan
Anannit Visuthibhan


The objectives of this study were to explore medication adherence in adolescents with epilepsy and to examine factors related to this phenomenon. The sample group consisted of 126 adolescents with epilepsy. The participants were selected by purposive sampling. The data were collected via questionnaires on demographic characteristics of adolescents with epilepsy, the Medication Adherence Report Scale,the Modified ENRICHD Social Support Instrument, the Provider-Patient Communication Scale, the Pediatric Epilepsy Side Effects Questionnaire, the Epilepsy Knowledge Scale,and the Self-efficacy for Appropriate Medication Use Scale. Data were analyzed using descriptive statistics and the Spearman rank correlation coefficient. The results showed that 92.90 % of the adolescents with epilepsy had good medication adherence. Perceived social support, provider-patient communication, and perceived self-efficacy were
positively related to medication adherence in adolescents with epilepsy with a statistical significance. However, the side effects of medication and the knowledge of epilepsy were not significantly related to medication adherence in adolescents with epilepsy. This
study recommends that perceived social support, provider-patient communication and perceived self-efficacy should be assessed and promoted to adolescents with epilepsy in order to enhance their medication adherence.
Keywords : Adolescents, Epilepsy, Medication adherence


Article Details

How to Cite
Kempka K, Patoomwan A, Visuthibhan A. Factors Related to Medication Adherence in Adolescents with Epilepsy. Nurs Res Inno J [Internet]. 2023 Apr. 12 [cited 2024 Jun. 16];29(1). Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/255814


World health organization. Epilepsy 2017 [cited 2017 February 20]. Available from: http://www.who.int/ mediacentre/factsheets/fs999/en/

Dalbem JS, Dalbem AS, Siqueira HH, Alvarenga RMP,Andraus MEC. Epilepsy prevalence in children and adolescents aged 0 -19 years-a door-to-door study. J Neurol Sci. 2015;357:196. doi:10.1016/j.jns.2015.08.679.

Farghaly WM, Abd Elhamed MA, Hassan EM, Soliman WT, Yhia MA, Hamdy NA. Prevalence of childhood and adolescence epilepsy in Upper Egypt (desert areas). Egypt J Neurol Psychiatr Neurosurg. 2018;54(1):34.doi:10.1186/s41983-018-0032-0.

Information Division Ramathibodi Hospital. The statistics of children with epilepsy receiving treatment at the pediatric outpatient department, Ramathibodi Hospital; 2559.

Minardi C, Minacapelli R, Valastro P, Vasile F, Pitino S,Pavone P, et al. Epilepsy in children: from diagnosis to treatment with focus on emergency. J Clin Med.2019;8(1):39.doi:10.3390/jcm8010039

Jones RM, Butler JA, Thomas VA, Peveler RC, Prevett M. Adherence to treatment in patients with epilepsy:associations with seizure control and illness beliefs.Seizure. 2006;15(7):504-8. doi:10.1016/j.seizure.2006.06.003.

Moffat C, Dorris L, Connor L, Espie CA. The impact of childhood epilepsy on quality of life: a qualitative investigation using focus group methods to obtain children’s perspectives on living with epilepsy. Epilepsy Behav. 2009;14(1):179-89. doi:10.1016/j.yebeh.


Kyngas H. Compliance with health regimens of adolescents with epilepsy. Seizure. 2000;9(8):598-604. doi:10.1053/seiz.2000.0470.

World Health Organization. ( 2003) . Adherence to longterm therapies: evidence for action. World Health Organization. Available from: http://apps.who.int/iris/handle/10665/42682

Malik MA, Shabbir N, Saeed M, Malik H, Mirza A.Medication nonadherence in children with epilepsy attending outpatient under-resourced community. J Pediatric Epilepsy. 2015;4(2):72-9. doi: 10.1055/s-0035-1555600.

Getnet A, Woldeyohannes SM, Bekana L, Mekonen T,Fekadu W, Menberu M, et al. Antiepileptic drug nonadherence and its predictors among people with epilepsy. Behav Neurol. 2016;2016:3189108. doi:10.1155/ 2016/3189108.

Shegaw M, Kassa R, Ali Y, Addissu N. Prevalence and associated factors of antiepileptic drug nonadherence among epileptic patients attending at outpatient department of Dilla University Referral Hospital, Dilla, Gedeo,SNNPR, Southern Ethiopia. Int J of Biosci and Med.

;1(2). doi:10.28933/ijbm-2017-07-1401.

Michie S, Miles J, Weinman J. Patient-centredness in chronic illness: what is it and does it matter?. Patient Educ Couns. 201403;51(3):197-206. doi:10.1016/s0738-3991(02)00194-5.

Pooya A, Akbar A. Drug compliance of children and adolescents with epilepsy. Seizure. 2005;14(6):393-5. doi:10.1016/j.seizure.2005.05.003.

Gabr WM, Shams ME. Adherence to medication among outpatient adolescents with epilepsy. Saudi Pharm J.2014;23(1):33-40. doi:10.1016/j.jsps.2014.05.003

Tan XC, Makmor-Bakry, M., Lau, C. L., Tajarudin, F.W., & Raymond, A. A. Factors affecting adherence to antiepileptic drugs therapy in Malaysia. Neurol Asia.2015;20(3):235-41.

López González FJ, Rodríguez Osorio X, Gil-Nagel Rein A, Carreño Martínez M, Serratosa Fernández J, Villanueva Haba V, et al. Drug-resistant epilepsy: definition and treatment alternatives. Neurología (English Edition).2015;30(7):439-46. doi:10.1016/j.nrl.2014.04.012.

Morita DA, Glauser TA, Modi AC. Development and validation of the Pediatric Epilepsy Side Effects Questionnaire. Neurology. 2012;79(12):1252-8.doi:10.1212/WNL.0b013e3182635b87.

Verma N, Tripathi, S., & Sharma, S. Drug compliance in children with epilepsy: cross-sectional study in New Delhi.Indian J child Health. 2016;3(4):311-3. doi:10.32677/IJCH.2016.v03.i04.010.

Qoul KZ, Qasem, D. A., Samawi, O. H., Matter, L. N.,Abo-tineg, S. I., & Abo-olem, M. Antiepileptic medication adherence in children with epilepsy at Queen Rania Al-Abdullah children hospital. Indian J Med Res Pharm Sci. 2015;2(10):16-23.

Chuaichum C. Factors related to medication adherence in patients with epilepsy [thesis]. Bangkok: Chulalongkorn University; 2012. (in Thai)

Kobau R, DiIorio C. Epilepsy self-management: a comparison of self-efficacy and outcome expectancy for medication adherence and lifestyle behaviors among people with epilepsy. Epilepsy Behav. 2003;4(3):217-25.doi:10.1016/s1525-5050(03)00057-x.

Noosorn N. Social support and health promotion. In:Noosorn N, editor. Health promotion in the community concept and practice. Bangkok: Chulalongkorn University publisher; 2010.

Pinprapapan E, Phanuthai S, Vannarit T, Srisuphan W. A causal model of adherence to therapeutic regimens among persons with hypertension. Pacific Rim Int J Nurs Res.2013;17(3):268-81.

WHO. Technical report No 498. International drug monitoring, the role of national centres, Geneva: The Institute; 1972. Available from: https://who-umc.org/media/2680/who-technical-report-498.pdf

Burns N, Grove SK. The practice of nursing research:conduct, critique and utilization. 5th ed. Missouri: Elsevier Saunders; 2005.

Martin B. Sample size for clinical trials 2011. Available from: https://www-users.york.ac.uk/~mb55/bsi_study/sampsz5.pdf

Horne R. The Medication Adherence Report Scale(MARS). University of Brighton; 1996.

Rungruangsiripan M, Sitthimongkol Y, Maneesriwongul W, Talley S, Vorapongsathorn T. Mediating role of illness representation among social support, therapeutic alliance,experience of medication side effects, and medication adherence in persons with schizophrenia. Arch Psychiatr Nurs. 2011;25:269-83. doi:10.1016/j.apnu.2010.09.002.

Polsook R, Aungsuroch Y, Thanasilp S. Medication adherence among persons with post-acute myocardial infarction. Songklanakarin J Sci Technol. 2016;38:611-20.

Vaglio J Jr, Conard M, Poston WS, O'Keefe J, Haddock CK, House J, Spertus, JA. Testing the performance of the ENRICHD social support instrument in cardiac patients.Health Qual Life Outcomes. 2004;2:24. doi:10.1186/1477-7525-2-24.

Kongsaktrakul C. A causal model of self-care behavior for adolescents with epilepsy [dissertation]. Chiangmai:Chiangmai University; 2006

Risser J, Jacobson TA, Kripalani S. Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in lowliteracy patients with chronic disease. J Nurs Meas.2007;15(3):203-19. doi:10.1891/106137 407783 095757.

Virag L, Murgas M, Kuzelova M. Pharmacotherapeutic adherence and quality of life in paediatric outpatients with epilepsy. Eur Pharm J. 2012;59(Supplement-VI): 76-83. doi:10.2478/v10219-012-0009-5.

Shallcross AJ, Becker DA, Singh A, Friedman D, Jurd R,French JA, et al. Psychosocial factors associated with medication adherence in ethnically and socioeconomically diverse patients with epilepsy. Epilepsy Behav.2015;46:242-5. doi:10.1016/j.yebeh.2015.01.034.

Worrkitkasemkul S. Research methodology for behavior and social science. Udon Thani: Udon Thani Rajabhat University; 2011. (in Thai)

Akbarbegloo M, Valizadeh L, Zamanzadeh V, Jabarzadeh F. The relationship between self-efficacy and psychosocial care in adolescents with epilepsy. Epilepsy Res Treat.2015;2015:756849. doi:10.1155/2015/756849.

Gurumurthy R, Chanda K, Sarma G. An evaluation of factors affecting adherence to antiepileptic drugs in patients with epilepsy: a cross-sectional study. Singapore Med J.2017;58(2):98-102. doi:10.11622/smedj.2016022.

Kangwal C, Kongsaktrakol C, Maneesriwongul W,Visudtibhan A. Factors related to medication adherence among children with epilepsy. Ramathibodi Nursing Journal. 2017;23(1):44-59. (in Thai)

Maiphom S, Leemingsawat W. Heath literacy of caregivers of children with epilepsy. Journal of Sport Science and Health. 2020;21(2):269-82. (in Thai)