Adherence and treatment outcome among epileptic patients of follow-up at Amanuel Specialized Mental Hospital, Ethiopia

Abstract

Epilepsy is treated with anti-epileptic drugs, aiming at controlling seizure without inducing adverse effects. The literature is sparse in treatment outcome of epileptic patients in resource poor settings. The aim of this study was therefore to assess adherence and treatment outcome among epileptic patients. A cross-sectional study was conducted among epileptic patients on follow-up at Amanuel Specialized Mental Hospital (ASMH). Patients who had follow up for at least two years were recruited and adherence and treatment outcome were evaluated through chart review and patient interview. Factors affecting adherence and seizure control were also determined using regression analysis. A total of 397 patients were evaluated, out of which 61% were males. Generalized tonic clonic seizure was the predominant (76.1%) form of seizure diagnosed. A large proportion of patients were managed with monotherapy (74.8%), phenobarbitone being the most commonly (60.5%) used single agent. About 70% of patients were adherent to treatment, but only 38.6% of the patients were seizure free for at least two years. Seizure free period and year of follow up were found to have significant association with adherence. Number of drugs, side effect burden, adherence and educational levels were found to have a significant association with seizure control status. The findings collectively indicate that health care providers should focus on adherence, treatment modality and side effect burden to control seizure. In addition, there must be a consideration of clinical assessment to withdraw treatment for those patients who were seizure free for at least two years.

Keywords: anti-epileptic drugs, epilepsy, treatment outcome, adherence, cross-sectional study