Barriers and enablers to antiseizure medication adherence in children with epilepsy: a systematic review using the theoretical domains framework (TDF) - Summary - MDSpire
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Identifying Factors Influencing Adherence to Antiseizure Medications in Pediatric Epilepsy: A Systematic Review Utilizing the Theoretical Domains Framework
To synthesize qualitative data using the theoretical domains framework (TDF) to identify the behavioral mechanisms associated with antiseizure medication (ASM) adherence in children with epilepsy.
Approach:
Systematic Review: The review followed PRISMA guidelines, conducting a comprehensive search across multiple databases and assessing study quality using the Critical Appraisal Skills Programme.
Data Analysis: Qualitative findings were extracted, analyzed, and synthesized using NVivo V.14 and mapped to the TDF.
Behavior Change Techniques: Behavior change techniques (BCTs) associated with identified TDF domains were identified using the Theory and Techniques Tool.
Key Findings:
Nineteen studies were included: 17 qualitative and two mixed-methods.
A total of 83 factors were identified, comprising 51 barriers and 32 enablers to ASM adherence.
Key barriers included poor communication between prescribers and parents, unpleasant taste, large tablet size, access issues, and fear of addiction.
Key enablers included parental prompting and understanding of treatment purpose.
Interpretation:
The findings describe the determinants of non-adherence, linking them to evidence-based behavior change techniques.
Limitations:
The review may be limited by the quality and heterogeneity of included studies.
Contrasting evidence on beliefs about consequences across different countries may affect generalizability.
Conclusion:
The study highlights the multifactorial nature of ASM adherence.
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