Factors Influencing Medication Non-Adherence among Patients with Epilepsy at a Tertiary Hospital in Ilorin, North Central Nigeria

Background: Epilepsy is a chronic neurological condition requiring consistent medication adherence to prevent seizure recurrence. In Nigeria, non-adherence to antiepileptic drugs is prevalent and linked to social stigma, poor drug availability, and cultural beliefs about the disease. This study assessed factors influencing medication non-adherence among patients with epilepsy at the University of Ilorin Teaching Hospital, Kwara State. Methods: A cross-sectional study recruited 200 epilepsy patients attending the neurology outpatient clinic. Non-adherence was assessed using the Medication Adherence Rating Scale (MARS). Factors including stigma, drug cost, side effects, and beliefs about epilepsy were evaluated using validated sub-scales. Results: Non-adherence was identified in 52 percent of patients. Significant predictors included internalized stigma (OR 2.8), drug unaffordability (OR 2.1), and traditional beliefs that epilepsy is spiritually caused (OR 1.9). Patients who received structured counselling showed better adherence rates (OR 0.5). Conclusion: Epilepsy medication non-adherence in Ilorin is multifactorial and deeply embedded in social and cultural contexts. Multi-pronged interventions addressing stigma, drug access, and patient education are essential to improve seizure control. Keywords: epilepsy, medication non-adherence, Ilorin, antiepileptic drugs, stigma