The effect of caregiver anxiety on medication adherence in children with epilepsy: The mediating effect of medication beliefs

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BACKGROUND: We used structural equation modelling to analyze the effect of caregiver anxiety on medication adherence and the mediating effect of medication beliefs in children with epilepsy in China. METHODS: Convenience sampling was used to continuously select children with epilepsy who met the inclusion criteria from January 2021 to June 2024. We generated a theoretical model of the interactions between medication beliefs, anxiety, and medication adherence. Structural equation modelling was used to analyze multiple mediating effects. RESULTS: Participants were 2334 children with epilepsy; 61.3 % had good medication adherence. Younger age, being an only child, place of residence, parents' marital status, being newly diagnosed, and caregiver anxiety score affected medication adherence. Of caregivers, 22.9 % had anxiety and adherence score was an anxiety influencing factor. Caregiver anxiety had a significant negative effect on medication adherence and necessity beliefs about the necessity of medication, and a significant positive effect on concerns about medication. Necessity beliefs had a significant positive effect on medication adherence. However, medication concerns had a significant negative effect on medication adherence. Necessity beliefs and concerns had significant mediating effects on the relationship between caregiver anxiety and medication adherence (44.5 % of the total effect). CONCLUSION: More than one-third of persons with epilepsy have poor medication adherence. Caregiver anxiety both directly affects medication adherence and indirectly affects it through the mediating role of medication beliefs. To improve medication adherence in persons with epilepsy, more attention should be paid to improving caregiver mental health and patients' medication understanding.

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