1.0 INTRODUCTION
Epilepsy is a major public health with serious physical, social and
psychological consequences that relies heavily on antiepileptic drugs
(AEDs), adherence to medication to achieve to seizure remission and
improve quality of life while avoiding unwanted
side-effects.(Abou-Khalil, 2016; Fadare et al., 2018; George et al.,
2015; Lyseng-Williamson, 2011; Olusanya et al., 2017)In a systematic
review among developing countries to determine magnitude, causes, and
possible intervention strategies, the overall estimated Treatment Gap
(TG) was 56/100. (Nwani et al., 2013) Inadequate skilled manpower, cost
of treatment, cultural beliefs, unavailability of AEDs were some of the
identified reason for the relatively high TG.(Nwani et al.,
2013)Furthermore, Adverse Drug Reaction(ADR) contributes significantly
to the TG and negatively impact on outcome, and quality of care, social
and economic burden in People With Epilepsy (PWE).(Adedapo et al., 2021;
Coleman & Pontefract, 2016; Habib et al., 2013)In a recent cohort study
among adults admitted to medical wards in southwestern Nigeria, aimed at
determining prevalence, incidence, risk factors and fatality of ADR,
anticonvulsant therapy accounted for 2.9% with Carbamazepine (CAP) and
phenytoin being the major culprit.(Adedapo et al., 2021)Cognitive
dysfunction, somnolence, irritability, behavioral issues, drowsiness,
gingival hyperplasia, depression, gastrointestinal disturbance, and
fatigue are some of the common ADR in PWE.(Du et al., 2019; Fadare et
al., 2018; Kaushik et al., 2019; Silvennoinen et al., 2019)ADR has been
established as a key factor of non-adherence, poor treatment outcome,
poor seizure control and increased hospitalizations and poor quality of
Life.(Adedapo et al., 2021; Yang et al., 2014)Gender, sex, genetic
influence, background chronic illness, polytherapy, inappropriate dose,
idiosyncratic reactions, seizure type, duration of use and type of AEDs,
idiosyncratic and dose dependent reaction are factors associated with
ADR (Abou-Khalil, 2016; Du et al., 2019; Meador et al., 2009; St. Louis,
2009). Liverpool Adverse Effect Profile (LAEP) is a reliable instrument
which has been tested as a good measure of ADR in PWE on AEDs across the
globe and has been correlated with medication adherence, depression
status and suicidal tendency, cognitive dysfunction, and level of
education.(Du et al., 2019; Fadare et al., 2018; Lee et al., 2014;
Olusanya et al., 2017; Yang et al., 2014) Morinsky Medication Adherence
Scale (MMAS) is an 8-item scale which has been previously validated and
extensively used severally in conditions like diabetes mellitus,
psychiatric disorders and hypertension among Nigeria cohorts with
description of good internal consistency and reliability. There is an
increasing need to develop appropriate strategy for effective early
identification and intervention to alleviate unacceptably growing
burden, morbidity and mortality associated with ADR in PWE. This study
is aimed at identifying factors associated with ADR and medication
adherence among patients in PWE.