Background Drug-resistant epilepsy (DRE) remains a significant clinical challenge, with many adults experiencing persistent seizures despite adequate trials of antiseizure medications. Early identification of factors associated with DRE is essential for timely intervention and optimized management. Objectives The research aimed to examine the demographic, clinical, and behavioral factors involved with DRE in adults and to establish the difference in the severity of seizures, treatment adherence, and illness-specific characteristics of the patients with and without DRE. Methods An analytical observational study was conducted on 460 adults with epilepsy in Lahore, Pakistan. Data were collected using structured questionnaires, including the National Hospital Seizure Severity Scale (NHS3) and the Medication Adherence Rating Scale (MARS). Associations were analyzed using Spearman correlations, Mann-Whitney U-tests, Kruskal-Wallis tests, and multivariate regression, with p 60 years had the opposite trend. Multivariate regression identified seizure severity, low adherence, younger age, male gender, longer disease duration, and seizure type as independent predictors of DRE. Conclusion High seizure severity, poor adherence, younger age, and certain seizure characteristics are strongly associated with DRE. Early monitoring, adherence support, and individualized interventions may reduce the burden of persistent seizures in adults.
Sarfraz et al. (Sat,) studied this question.