A cross-sectional questionnaire-based study of medication adherence in children suffering from epilepsy attending pediatric out-patient department at a tertiary care teaching hospital


  • Khilen P. Joshi Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India
  • Amol L. Bhave Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India
  • Pratit P. Vyas Department of Pharmacology, Medical College Baroda, Vadodara, Gujarat, India




Cross-sectional study, Epilepsy, Medication adherence, Pediatric


Background: Epilepsy is a common chronic disease presenting during childhood that requires long-term treatment. Rates of adherence to antiepileptic drugs are variable in children ranging from 25% to 75%. Non-adherent patients are more likely to experience frequent and recurrent seizures which drastically impact the health of the patient. This study was therefore conducted in order to assess the medication adherence of children suffering from epilepsy to the prescribed anti-epileptic drug therapy.

Methods: Children diagnosed with epilepsy aged 6-18 years were enrolled in the present cross-sectional questionnaire-based study after prior written informed consent and written informed assent. Children with co-morbidities were excluded from the study (as diagnosed by the Paediatrician). The case record form was filled after interviewing the patients. A questionnaire based on the Morisky medication adherence scale-8 (MMAS) was used to evaluate the quality of life of children.

Results: Total 243 patients got enrolled in the study. GTCS was found to be the most common type of epilepsy. Valproate was the most commonly used agent. Out of the 243 patients in total, 201 patients (83%) showed high adherence, 24 patients (10%) showed medium adherence and 18 patients (7%) showed poor adherence to the treatment prescribed. Patients on monotherapy showed higher adherence rates than patients on polytherapy. Medication adherence was highest with Valproate among monotherapy and valproate + carbamazepine among poly-therapy.

Conclusions: We conclude that monotherapy with anti-epileptic agents and patient satisfaction is positive predictors of medication adherence leading to a lesser impact of the disease on the child and improved health.


Gopinath B, Radhakrishnan K, Sankara Sarma P, Jayachandran D, Alexander A. A questionnaire survey about doctor-patient communication, compliance and locus of control among South Indian people with epilepsy. 2000;1-10.

Hamdy S, Saleh A, Elsayed M, Mohammed H, Abounaji A. Health Related Quality of Life in Egyptian Children and Adolescents with Epilepsy. 2021;10.

Nagabushana D, Agadi JB. Impact of epilepsy and antiepileptic drugs on health and quality of life in Indian children. Epilepsy Behavior. 2019;93:43-8.

Sabaté Eduardo, World Health Organization. Adherence to long-term therapies: Evidence for Action. World Health Organization. 2003. Available at: https://apps.who.int/iris/handle/10665/42682. Accessed on 12th February 2023.

Nazziwa R, Kakooza Mwesige A, Obua C, Ssenkusu JM, Mworozi E. Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting. Pan African Med J. 2014;17.

The Morisky Medication Adherence Scale: An Overview. 2022;21.

Nagesh A, Gade A, Puchchakayala G, Bhava S, Kagitapu S, Madanu S et al. Assessment of Health-Related Quality of Life in Children with Epilepsy Using Quality of Life in Childhood Epilepsy Questionnaire (Qolce-55) in Tertiary Care Hospital. J Basic Clin Pharm. 2017;8(2).

Yogarajah M, Mula M. Social cognition, psychiatric comorbidities, and quality of life in adults with epilepsy. Epilepsy and Behavior. 2019;100.

Mistry R, Solanki K, Prajapati H, Doshi T, Trivedi H. Drug utilization pattern of antiseizure drugs and their adverse effects in the pediatric population, in a tertiary care hospital attached to a medical college. Int J Basic Clin Pharmacol. 2014;3(2):336.

Malhi P, Singhi P. Correlates of quality of life with epilepsy. Indian J Pediatr. 2005;72(2):131-5.

Malhi P, Annam A, Singhi P. Psychopathology and Quality of Life in Children with Epilepsy: A Cross-Sectional Study. Indian J Pediatr. 2021;88(7):712-4.

Chauhan S, Prasad PL, Khurana B, Gahalaut P. Self-reported medication adherence to antiepileptic drugs and treatment satisfaction among paediatric patients having epilepsy: A cross sectional study from the Indian subcontinent. Sri Lanka Journal of Child Health. 2018;47(2):129-36.

Malhotra S, Patel K, Patel V, Bhatt K. Drug utilization in pediatric neurology outpatient department: A prospective study at a tertiary care teaching hospital. J Basic Clin Pharm. 2014;5(3):68.

S HS, U BZ. Antiepileptic drug utilisation and seizure outcome among paediatric patients in a Malaysian public hospital. Original Article Singapore Med J. 201(0):21.

Sweileh WM, Ihbesheh MS, Jarar IS, Taha ASA, Sawalha AF, Zyoud SH et al. Self-reported medication adherence and treatment satisfaction in patients with epilepsy. Epilepsy and Behavior. 2011;21(3):301-5.

Asadi-Pooya AA. Drug compliance of children and adolescents with epilepsy. Seizure. 2005;14(6):393-5.

Molugulu N, Gubbiyappa K, Vasudeva Murthy C, Lumae L, Mruthyunjaya A. Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur. J Basic Clin Pharm. 2016;7(4):105.

Gabr WM, Shams MEE. Adherence to medication among outpatient adolescents with epilepsy. Saudi Pharmaceutical J. 2015;23(1):33-40.

Dawood OT, Izham M, Ibrahim M, Palaian S. Medication compliance among children. World J Pediatr. 2010;6(3):200-2.

Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;(2).

Lask B. Motivating children and adolescents to improve adherence. J Pediatr. 2003;143(4):430-3.

Nevins TE. Non-compliance and its management in teenagers. Pediatr Transplant. 2002;6(6):475-9.

Qoul KZ, Qasem DA, Samawi OH, NMatter L, Abo-tineh SI, Abo-olem M et al. Impact Factor (PIF): 2.672 antiepileptic medication adherence in children with epilepsy at queen Rania al-Abdullah children hospital. Royal Medical Services. 2015;1.

Sonny Johnbull O, Farounbi B, Adeleye AO, Ogunrin O, Uche AP. Evaluation of Factors Influencing Medication Adherence in Patients with Epilepsy in Rural Communities of Kaduna State, Nigeria. Neurosci Med. 2011;2:299-305.

Gao Y, Tang X, Wen Y, Qian D, Pan X, Zhang L. Effects of the hospital-community-family ternary linkage continuous nursing model on compliance, cognitive function, resilience, and quality of life for children with epilepsy: a retrospective study. Transl Pediatr. 2022;11(2):239-48.

Malik M, Shabbir N, Saeed M, Malik H, Mirza A. Medication Nonadherence in Children with Epilepsy Attending Outpatient Clinics in Under-Resourced Community. J Pediatr Epilepsy. 2015;04(02):072-9.

Yang C, Yu D, Li J, Zhang L. Prevalence of medication adherence and factors influencing adherence to antiepileptic drugs in children with epilepsy from western China: A cross-sectional survey. Epilepsy and Behavior. 2020;104.

Buck D, Jacoby A, Baker GA, Chadwick DW. Factors influencing compliance with antiepileptic drug regimes. Seizure. 1997;6(2):87-93.




How to Cite

Joshi, K. P., Bhave, A. L., & Vyas, P. P. (2023). A cross-sectional questionnaire-based study of medication adherence in children suffering from epilepsy attending pediatric out-patient department at a tertiary care teaching hospital. International Journal of Basic & Clinical Pharmacology, 12(4), 563–569. https://doi.org/10.18203/2319-2003.ijbcp20231892



Original Research Articles