A Systematic Review and Meta-analysis of Anti-epileptic Medication Non-adherence Among People with Epilepsy in Ethiopia

Overview

Journal Arch Public Health

Publisher Biomed Central

Date 2020 Oct 19

PMID 33072315

Citations 20

Authors

Zelalem Belayneh

Birhanie Mekuriaw

Affiliations

Soon will be listed here.

Abstract

Background: Epilepsy is the common neurological disorder in the world, affecting approximately 50 million people. Anti-epileptic medication non-adherence can be a reason for long term hospitalization, repeated emergency seizure attacks, increased health care cost and frequent absence of work due to poor seizure control. Existed studies of anti-epileptic medication non-adherence in Ethiopia have reported great discrepant and inconsistent results which calls a growing demand of systematic review and meta-analysis. Therefore, this review aimed to show the pooled prevalence of anti-epileptic medication non-adherence among people with epilepsy attending outpatient department.

Methods: Literatures were searched from the PubMed/Medline, Science Direct, PsycINFO, Hinnari and Google Scholar for grey literatures. The data were extracted using a prepared data extraction Microsoft Excel format. The data were analyzed using STATA- version 14 (software). The I test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval.

Results: A total of fourteen primary studies of anti-epileptic medication non-adherence were included in the review showing the pooled prevalence of anti-epileptic medication non-adherence to be 39.77 (95% CI: 32.44, 47.10). The highest prevalence [44.13 95% CI: (29.92, 58.34)] was observed among studies used both self-report and medical record review together, and studies used only self-report to screen medication none adherence had the lowest prevalence [37.95% (24.50, 51.41)]. Presence of co-morbid illness [2.27 (95%CI: 1.01, 5.12)], medication side effects [1.84(95% CI: 1.43, 2.38)], substance use or drug abuse [2.01(95% CI: 1.27, 3.20)] had statistically significant association with anti-epileptic medication non-adherence.

Conclusion: In this review, we found that there is a high burden of anti-epileptic medication non-adherence among people with epilepsy in Ethiopia. This demonstrates a need for clinicians to give more attention for the monitoring and evaluation of anti-epileptic medication adherence in the health care service. We also highly recommended for the adoption of a standardized and contextualized adherence screening tools.

Trial Registration: [CRD42019137631].

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