Medication Barriers in Pediatric Patients With Epilepsy.
Publication/Presentation Date
1-30-2026
Abstract
BACKGROUND: To identify the most common medication adherence barriers among pediatric patients with epilepsy, standardized screening was implemented in a child neurology division using the Barriers to Adherence Tool.
METHODS: The Barriers to Adherence Tool was implemented as a standardized previsit questionnaire for follow-up encounters for seizures/epilepsy. Responses from July 2021 to March 2025 were analyzed.
RESULTS: The questionnaire was completed for 12,466 of 16,808 (74%) follow-up encounters for 5251 patients. At least one barrier was reported at 4351 (35%) encounters with completed questionnaires. The most common barriers included side effects (1612 barriers endorsed; 25%), does not control seizures (1000; 16%), trouble remembering medication (792; 12%), dislike medication taste (684; 11%), other (592; 9%), run out of medication (363; 6%), and too many medications/doses (320; 5%). Barriers were more often reported among patients who self-reported as Black/African American, experienced frequent seizures, or took more than one antiseizure medication. Conversely, barriers were reported less often among patients who self-reported as White, were seizure free or experienced infrequent seizures, or took one antiseizure medication. Among the 1166 patients who completed the questionnaire multiple times and endorsed a barrier at the first encounter, reported barriers were fewer at the last encounter for 770 patients (66%), unchanged for 277 patients (24%), and increased for 119 patients (10%).
CONCLUSIONS: Screening for medication barriers was feasible for a large cohort of patients in a sustainable and repeatable manner, and barriers were common. Future improvement initiatives may focus on improving common barriers.
Volume
177
First Page
140
Last Page
147
ISSN
1873-5150
Published In/Presented At
Molisani, S. E., Kaufman, M. C., Tencer, J., Fitzgerald, M., Witzman, S., Gonzalez, A. K., Ramos, M., DiGiovine, M., Kessler, S. K., McDonnell, P. P., McKee, J., Melamed, S., Prelack, M., Tefft, S., & Abend, N. S. (2026). Medication Barriers in Pediatric Patients With Epilepsy. Pediatric neurology, 177, 140–147. Advance online publication. https://doi.org/10.1016/j.pediatrneurol.2026.01.016
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
41689990
Department(s)
Department of Pediatrics
Document Type
Article