Medication adherence in epilepsy - the role of adverse drug reactions and patient knowledge-attitude-behavior

Sep 29, 2026

Uploaded by Ben

Medication adherence in epilepsy varies widely and is frequently undermined by adverse drug reactions (ADRs). Patient knowledge, attitudes, and behavior are also recognized as key determinants of whether treatment is followed. This cross-sectional study evaluated ADR types and knowledge-attitude-behavior factors and analyzed their relationships with adherence. Using Indonesian versions of validated instruments, it drew data from two time periods (2019 and 2022) and applied multivariate logistic regression.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Background

Medication adherence challenges in epilepsy

Role of adverse drug reactions

Role of knowledge, attitudes, and behavior

Methods

Study design and participants

Measures and instruments

Data collection and statistical analysis

Results

Adherence rates across periods

Association between ADRs and non-adherence

Knowledge scores and adherence

Sex differences in adherence

Conclusions

Implications for patient support and interventions

Jannah et al. Acta Epileptologica (2026) 8:1 [https://doi.org/10.1186/s42494-025-00237-z](https://doi.org/10.1186/s42494-025-00237-z) Acta Epileptologica RESEARCH Open Access Medication adherence in epilepsy: the role of adverse drug reactions and patient knowledge-attitude-behavior Ana Hulliyyatul Jannah1†, Nadia Devianca2†, Retnosari Andrajati1, Fitri Octaviana2, Winnugroho Wiratman2, Luh Ari Indrawati2, Adrian Ridski Harsono2, Manfaluthy Hakim2, Ahmad Yanuar Safri2, Nurul Fadli2 and Astri Budikayanti2* Abstract Background Adherence to epilepsy treatment varies greatly and is often compromised by adverse drug reactions. Spontaneous reporting of these reactions has improved pharmacovigilance in many countries. Knowledge, attitudes, and behavior are also key factors influencing treatment adherence. This study aimed to investigate the types of adverse drug reactions in epilepsy, as well as the knowledge, attitudes, and behavior of patients, and how these factors relate to medication adherence. Methods This cross-sectional study assessed adverse drug reactions using the Indonesian version of the Liverpool Adverse Event Profile and medication adherence with the Morisky Adherence Questionnaire. Knowledge, attitude and behavior were measured using a self-reported Indonesian knowledge-attitude-behavior questionnaire. Data were collected at two periods of time (2019 and 2022), in which the first period measured adherence, and adverse drug reactions, while the second period measured adherence, and adverse drug reactions, alongside knowledge, attitude, and behavior. Data were gathered from epilepsy patients at the neurology outpatient clinic at Cipto Mangunkusumo National Referral Hospital, and analyzed using Chi-square, likelihood ratio, independent t-test, or Mann–Whitney U Tests, followed by multivariate logistic regression. Results Adherence rates in both periods exceeded 50%(50 . 88% vs. 55. 70%) . Adverse drug reactions were reported by 78 . 07% of subjects, and were significantly associated with non-adherence (P = 0 . 007) . The mean knowledge score was 15.41 ± 3 . 83, and lower knowledge scores were linked to higher odds of non-adherence. Although not statistically significant (P = 0 . 077), higher knowledge scores showed a trend toward more frequent reporting of adverse drug reactions. Female subjects had higher odds of adherence compared to males (P = 0 . 013) . Conclusions Our findings suggest that adverse drug reaction reporting, along with patient knowledge, attitudes, and behavior, are important factors associated with medication adherence. Targeted interventions by healthcare providers to support these areas may help improve adherence in people with epilepsy. Keywords Epilepsy, Adverse drug reaction, Knowledge, Attitude, Behavior, Medication adherence †Ana Hulliyyatul Jannah and Nadia Devianca contributed equally to this work, and both of them are considered as co-first authors. *Correspondence: Astri Budikayanti [astri.budikayanti@ui.ac.id](astri.budikayanti@ui.ac.id) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses

FAQs

How did the study measure medication adherence and adverse drug reactions?

Medication adherence was assessed using the Morisky Adherence Questionnaire, while adverse drug reactions were evaluated with the Indonesian version of the Liverpool Adverse Event Profile.

What were the main findings about the relationship between ADRs and adherence?

Adverse drug reactions were reported by 78.07% of subjects and were significantly associated with non-adherence (P = 0.007).

Which patient factors were linked to adherence outcomes?

Lower patient knowledge scores were associated with higher odds of non-adherence, and female subjects showed higher odds of adherence than males (P = 0.013).

What do the study’s conclusions suggest for improving adherence in epilepsy?

Targeted interventions by healthcare providers that support patient reporting of ADRs and improve knowledge, attitudes, and behavior may help enhance adherence.

Sep 29, 2026

Uploaded by Ben