Objectives: Epilepsy is a common neurological disorder but people living with epilepsy (PLWE) can live a healthy life with optimal anti-epileptic drugs (AEDs) therapy. The primary purpose of this study was to determine adherence and health-related quality of life (HRQoL) in PLWE. Secondary aims were to assess association between adherence and HRQoL and determine predictors of HRQoL in PLWE in Pakistan.

Methods: A study was conducted among PLWE receiving treatment from two tertiary care hospitals of Islamabad and Rawalpindi, Pakistan. The HRQoL and adherence were assessed with Urdu versions of Quality of Life in Epilepsy-31 (QOLIE-31), and Medication Adherence Rating Scale (MARS). Relationship between HRQoL and adherence was assessed by Pearson product-moment correlation coefficient. Forced entry multiple linear models were used to determine relationship of independent variables with HRQoL while controlling for confounders.

Results: 219 PLWE with a mean (±Standard Deviation) age, 34.18 (±13.71) years, participated in this study. The overall weighted mean HRQoL score was (51.6 ±17.1), and a mean score for adherence was 6.17 (±2.31). There was a significant association between adherence and HRQoL in PLWE (Pearson’s Correlation= 0.820 - 0.930; p = 0.000). Multiple linear regression found adherence (β=16.8; p =0.000), male gender (β=10.0; p = 0.001), employment status (employed: β=7.50; p = 0.030), level of education (Tertiary: β=0.910; p = 0.010), duration of epilepsy (>10 years: β= - 0.700; p = 0.000), and age (≥46 years: β= -0.680; p = 0.000), and AED therapy (polypharmacy: β= 0.430; p = 0.010) as independent predictors of HRQoL in PLWE from Pakistan.

Conclusions: The findings suggest PLWE have suboptimal adherence which affects their HRQoL. Independent factors such as male gender, employment status and duration of epilepsy are predictors of HRQoL. During routine clinical consultations, medication adherence should be evaluated and emphasized in order to enhance HRQoL.