Assessment of Psychoeducation on Patients’ Adherence to Antiepileptic Drugs in Federal Neuro Psychiatric Hospital, Maiduguri

Psychoeducation and patients’ adherence to antiepileptic drugs

Abstract

Abstract 
Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. 
Among patients on treatment with antiepileptic drugs, medication adherence remains a major challenge with 
consequences such as poor seizure control. This study examined the effect of psycho-educational intervention on 
patients’ adherence to antiepileptic drugs. In this randomized controlled interventional study on a cohort of patients 
with epilepsy attending the outpatient clinic of the Federal Neuro Psychiatric Hospital, Maiduguri, one hundred and 
ninety (190) patients were randomized into control (n=95) and Intervention (n=95) groups. Patients in both groups 
received standard care as practiced in the hospital. In addition, the intervention group received three sessions of 
psycho-education on epilepsy focusing on basic knowledge regarding epilepsy, myths and truths about epilepsy, 
diagnosis, treatment with emphasis on drug adherence, living with epilepsy and coping strategies delivered at 
follow up visits for 3 months. Patients’ drug adherence was measured using the eight-item Morisky Medication 
Adherence Scale (MMAS-8) for both groups while socio-demographic and clinical variables were collected using 
structured form at baseline. Medication adherence was measured in both groups post intervention. Data was 
analyzed using SPSS version 25 and expressed as frequency while paired sample t test was used to compare 
outcome in both groups. The majority of the participants in this study were male (57.1%), unemployed (32.1%), and 
51.9% not married. The mean age of control and intervention groups are 25.55 ± 6.02 and 26.34 ± 6.18 
respectively. Most of the patients have Focal type of epilepsy (61.5%). Majority of the patients are on monotherapy 
(67.3%) with carbamazepine as the most prescribed antiepileptic drugs. There was no significant difference (p= 
0.286) between the mean MMAS score before and after the intervention for the control group whereas the mean 
MMAS scores of the intervention group were 5.12±0.64 and 6.99±0.76 before and after psycho-education, 
respectively (p= 0.000).The rate of medication adherence was observed to be low in this study. There was no 
association between medication adherence and patient-related variables. However, psycho-education was shown to 
improve medication adherence significantly.