Determinants of Antiepileptic Medication Adherence: Examining the Role of Patient Knowledge, Beliefs, Travel Distance, and Social Support
Rebecca Nyaguthii Mwengi *
Department of Nursing, Kenya Medical Training College, Nairobi, Kenya and Department of Nursing, Chuka University, Chuka, Kenya.
Josephat Kiongo
Department of Nursing, Chuka University, Chuka, Kenya.
Lucy Gitonga
Department of Nursing, Chuka University, Chuka, Kenya.
Catherine Waigwe Mwaura
Department of Nursing, Kenya Medical Training College, Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Aim: This study investigated the associations of patient knowledge, beliefs, distance to a health facility, and social support with adherence to antiepileptic medication.
Study Design: The study adopted a cross-sectional design.
Place and Duration of Study: The study was conducted among adults with epilepsy in Kitui Central Sub-County between June and July 2021.
Methods: A sample of 192 respondents was recruited. A two-stage sampling technique was used, whereby purposive sampling identified Kitui Level 4 Hospital and the Wanzoa, Itoleka, Miambani, and Katulani health centres. This was followed by random sampling of 39 patients with epilepsy attending each health facility. Descriptive statistics were used to summarise the prevalence of adherence to antiepileptic medication, knowledge of epilepsy, and beliefs about epilepsy. Chi-square tests assessed the associations of knowledge, beliefs, distance to a health facility, and social support with the prevalence of antiepileptic medication adherence. Ethical clearance was obtained from the Chuka University Research and Ethics Committee and NACOSTI. Permission was obtained from the relevant administrators in Kitui County, and consent was obtained from the respondents.
Results: The prevalence of adherence to antiepileptic medication was 45.3%. Most respondents had knowledge of epilepsy (82.6%), whereas 71.6% held negative beliefs about epilepsy. Beliefs about epilepsy (χ²(1, N = 190) = 9.539, p = 0.002), distance to a health facility (χ²(3, N = 190) = 13.846, p = 0.003), and social support (χ²(1, N = 190) = 5.752, p = 0.016) were significantly associated with adherence to antiepileptic medication.
Conclusion: Antiepileptic medication adherence was suboptimal among people with epilepsy in Kitui Central Sub-County. The identified determinants underscore the need for interventions that address psychosocial factors, stigma, and access to healthcare alongside patient education.
Keywords: Antiepileptic medication, medication adherence, epilepsy knowledge, illness beliefs, travel distance, healthcare access, social support