1.0 INTRODUCTION
Epilepsy is a major public health with serious physical, social and psychological consequences that relies heavily on antiepileptic drugs (AEDs), adherence to medication to achieve to seizure remission and improve quality of life while avoiding unwanted side-effects.(Abou-Khalil, 2016; Fadare et al., 2018; George et al., 2015; Lyseng-Williamson, 2011; Olusanya et al., 2017)In a systematic review among developing countries to determine magnitude, causes, and possible intervention strategies, the overall estimated Treatment Gap (TG) was 56/100. (Nwani et al., 2013) Inadequate skilled manpower, cost of treatment, cultural beliefs, unavailability of AEDs were some of the identified reason for the relatively high TG.(Nwani et al., 2013)Furthermore, Adverse Drug Reaction(ADR) contributes significantly to the TG and negatively impact on outcome, and quality of care, social and economic burden in People With Epilepsy (PWE).(Adedapo et al., 2021; Coleman & Pontefract, 2016; Habib et al., 2013)In a recent cohort study among adults admitted to medical wards in southwestern Nigeria, aimed at determining prevalence, incidence, risk factors and fatality of ADR, anticonvulsant therapy accounted for 2.9% with Carbamazepine (CAP) and phenytoin being the major culprit.(Adedapo et al., 2021)Cognitive dysfunction, somnolence, irritability, behavioral issues, drowsiness, gingival hyperplasia, depression, gastrointestinal disturbance, and fatigue are some of the common ADR in PWE.(Du et al., 2019; Fadare et al., 2018; Kaushik et al., 2019; Silvennoinen et al., 2019)ADR has been established as a key factor of non-adherence, poor treatment outcome, poor seizure control and increased hospitalizations and poor quality of Life.(Adedapo et al., 2021; Yang et al., 2014)Gender, sex, genetic influence, background chronic illness, polytherapy, inappropriate dose, idiosyncratic reactions, seizure type, duration of use and type of AEDs, idiosyncratic and dose dependent reaction are factors associated with ADR (Abou-Khalil, 2016; Du et al., 2019; Meador et al., 2009; St. Louis, 2009). Liverpool Adverse Effect Profile (LAEP) is a reliable instrument which has been tested as a good measure of ADR in PWE on AEDs across the globe and has been correlated with medication adherence, depression status and suicidal tendency, cognitive dysfunction, and level of education.(Du et al., 2019; Fadare et al., 2018; Lee et al., 2014; Olusanya et al., 2017; Yang et al., 2014) Morinsky Medication Adherence Scale (MMAS) is an 8-item scale which has been previously validated and extensively used severally in conditions like diabetes mellitus, psychiatric disorders and hypertension among Nigeria cohorts with description of good internal consistency and reliability. There is an increasing need to develop appropriate strategy for effective early identification and intervention to alleviate unacceptably growing burden, morbidity and mortality associated with ADR in PWE. This study is aimed at identifying factors associated with ADR and medication adherence among patients in PWE.