Published in PLOS One on 2026-08-21, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Ronald Kibirige, Marianna Agaba Nyangire, Mark Kaddumukasa, Christine Muhumuza, Christopher Burant, Shirley Moore, Elly T Katabira, Martha Sajatovic, Jane Tugume, John Nsubuga, Nazarius Mbonna Tumwesigye, Aggrey David Mukose, Marwan Al-Nimer, Hiroki Annaka
Source: PLOS One • DOI 10.1371/journal.pone.0356494
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Epilepsy is a common neurological disease especially in Sub-Saharan Africa. Medication adherence is essential in seizure control; however, majority of patients living with epilepsy have poor adherence to anti- seizure medications. The purpose of this study was to determine the prevalence, the factors associated with, and the experiences with adherence to anti-seizure medications among people living with epilepsy attending a community- based epilepsy clinic in Buikwe District and Mukono General Hospital in Mukono District, central-Uganda.
In this cross-sectional mixed methods study, 277 participants were enrolled and 20 in-depth interviews were conducted from April to July 2024. Socio-demographics and treatment related information were collected using structured questionnaires. Medication adherence was measured using the standardized 8- item Morisky Medication Adherence Scale. Modified Poisson regression was done to determine factors associated with adherence to anti-seizure medications. Thematic analysis was conducted to explore participant’s experiences with adherence to anti-seizure medications.
The overall prevalence of adherence to anti-seizure medications was 66.5%. Factors significantly associated with adherence to Anti-seizure medications were earning a modest monthly income, adjusted prevalence ratios [aPR], (aPR 1.29; CI 1.13-1.53), receiving an inadequate treatment dosage (aPR 0.80; 95% CI 0.64-0.92), waiting for three or more hours at the facility (aPR 0.79: 95% CI 0.61-0.91), and being aged 30 to 34 years (aPR 0.71: CI 0.53-0.95). Key themes describing experiences with adherence to anti-seizure medications included fear of stigmatization, fear of injury and loss of life, social support, financial burden, individual motivation, misconceptions about anti-seizure medications, and limited awareness about their effectiveness.
This study revealed that about two- thirds of people living with epilepsy were adherent to anti-seizure medications. There is a need to implement strategies such as incorporating a medication adherence tool into routine patient care to improve adherence in our settings.
Introduction
Epilepsy is a chronic neurological disorder affecting approximately 50 million people globally. It is estimated that 80% of people living with epilepsy (PLWE) reside in developing countries like Uganda [1,2]. The crude prevalence of epilepsy in Uganda is reported to be 16.9 per 1000 persons [3]. The risk of premature death due to epilepsy is 3 times higher than for the general population, especially among those not receiving regular anti-seizure medications [4]. Anti-seizure medications (ASMs) remain a mainstay of epilepsy treatment with about 70% of PLWE becoming seizure free with ASM treatment [5]. Nearly 90% of PLWE in low and middle- income countries are not receiving appropriate treatment, which could be due to low availability of ASMs, misconceptions about ASMs, perceived epilepsy stigma and cultural attitudes. Thesemay lower the patient’s level of adherence to treatment [6]. Adherence is the most important modifiable factor that can improve treatment outcomes and reduce mortality [7].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Ronald Kibirige, Marianna Agaba Nyangire, Mark Kaddumukasa, Christine Muhumuza, Christopher Burant, Shirley Moore, Elly T Katabira, Martha Sajatovic, Jane Tugume, John Nsubuga, Nazarius Mbonna Tumwesigye, Aggrey David Mukose, Marwan Al-Nimer, Hiroki Annaka. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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