Perceived stigma and adherence in epilepsy: Evidence for a link and mediating processes.

OBJECTIVE: This study tested whether perceived epilepsy-related stigma is associated with adherence in people living with epilepsy and if information, motivation, and behavioral skills are potential pathways underlying the stigma-adherence link.

METHODS: We surveyed persons living with epilepsy between the ages of 18 and 65 (N=140) using an online questionnaire to assess medication adherence and perceived epilepsy-related stigma. In addition, participants reported their level of information, motivation, and behavioral skills.

RESULTS: Higher perceived epilepsy-related stigma was associated with lower medication adherence (r=-0.18, p<.05). Higher perceived stigma was associated with lower levels of information (r=-0.28, p<.05), motivation (r=-0.55, p<.05), and behavioral skills (r=-0.41, p<.05), and the link between stigma and adherence was fully explained by information, motivation, and behavioral skills, i.e., the effect of stigma on adherence was fully mediated (c=-0.18, p<.05 reduced to c'=0.06, p=.48).

CONCLUSION: Perceived epilepsy-related stigma is problematic for maintaining the prescribed medication regimen in people living with epilepsy. The information-motivation-behavioral skills model is a useful framework for understanding the pathways linking perceived stigma and adherence in this population.