Clinical Report: Identifying Factors Influencing Adherence to Antiseizure Medications in Pediatric Epilepsy

Overview

This systematic review identifies 83 factors influencing adherence to antiseizure medications (ASMs) in children with epilepsy, highlighting both barriers and enablers.

Background

Adherence to antiseizure medications is critical for effective seizure management in children with epilepsy, yet non-adherence rates are alarmingly high, ranging from 26% to 79%. Understanding the multifactorial nature of adherence is essential. This study utilizes the theoretical domains framework to systematically analyze qualitative data related to ASM adherence.

Data Highlights

Key Findings

• Key barriers include poor communication between prescribers and parents and unpleasant medication taste.
• Enablers include parental prompting and understanding of treatment purpose.
• Fear of addiction and stigma are significant emotional barriers affecting adherence.
• Access to ASMs is a critical environmental factor influencing adherence.
• Contrasting beliefs about consequences of ASM use were observed across different countries.

Clinical Implications

Recognizing the diverse factors influencing ASM adherence in pediatric epilepsy is important for enhancing treatment strategies.

Conclusion

The findings from this systematic review provide a comprehensive understanding of the determinants of non-adherence to ASMs in children with epilepsy.

Related Resources & Content

1. BMJ Paediatrics Open, 2026 -- Barriers and enablers to antiseizure medication adherence in children with epilepsy: a systematic review using the theoretical domains framework (TDF)
2. Drugs - Real World Outcomes — Monitoring Adverse Drug Reactions in Inpatients Treated with Newer Antiepileptic Medications Through Systematic Analysis of Routine Clinical Data
3. Drug Safety — An Evaluation of Approaches for Tracking Adverse Events in Pediatric Psychopharmacology Research Trials
4. Frontiers in Pediatrics — Efficacy and Safety of Perampanel as the First Medication for Children with Newly Diagnosed Epilepsy: A Real-World Single-Center Prospective Observational Study
5. BMC Psychiatry (Springer) — Ethiopia's Adult Epilepsy Patients: A Systematic Review and Meta-Analysis on Depression Prevalence and Contributing Factors, 2025
6. NICE Guidance on Epilepsies in Children
7. American Epilepsy Society Clinical Practice Guideline: Infantile Epilepsy
8. On Time Saves Lives: Survey Insights and Position Statement from the American Epilepsy Society on Barriers to Antiseizure Medication Access - Marjorie E. Bunch, Jessica Falco-Walter, Sasha Alick-Lindstrom, Abrar O. Al-Faraj, Brandy E. Fureman, James Herbst, Lisa C. Garrity, Shilpa Klocke, Alain Lekoubou, Lara V. Marcuse, Lauren Orciuoli, 2026
9. Barriers and enablers to antiseizure medication adherence in children with epilepsy: a systematic review using the theoretical domains framework (TDF) | BMJ Paediatrics Open
10. Global patterns and predictors of anti-seizure medication adherence in pediatric epilepsy: A systematic review and meta-analysis - ScienceDirect
11. Safety and efficacy of one-dose nocturnal levetiracetam for the treatment of self-limited epilepsy with centrotemporal spikes: a randomized clinical trial | Scientific Reports
12. The eACT study design and methods: A sequential, multiple assignment, randomized trial of A novel adherence intervention for youth with epilepsy - ScienceDirect