Medication nonadherence common and complex among adults with epilepsy

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  • Systematic review found high prevalence (29%-66%) of nonadherence in adults taking antiepileptic drugs (AEDs).
  • Authors advise regular assessment of adherence for patients taking AEDs.
Why this matters
  • AED nonadherence has been associated with poor QoL, suboptimal clinical outcome, and increased mortality.
  • First systematic review to explore barriers to medication adherence among adults with epilepsy.

Study design

  • Systematic review of articles from MEDLINE, CINANL, PsycINFO, EMBASE, and Cochrane databases for articles on epilepsy including patients >18 y prescribed AEDs that included adherence measurements.
  • 8 studies included.
  • Funding: None.

Key results

  • High prevalence of nonadherence (29%-66%).
  • AED nonadherence associated with beliefs about medications (perception of true need and sensitivity to adverse effects), depression and anxiety, poor self-administration of medication (forgetfulness and reports of not having time), uncontrolled recent seizures, medication complexity (dosing times, instructions), poor physician-patient relationship, and lack of social support.
  • Adherence seemed to improve with age.
  • Nonadherence had negative effect on QoL via poor seizure control.


  • Heterogeneity of studies.