Antiseizure Medication Sharing in Low-Resource Rural Settings: A Qualitative Study Using Case Narratives

Background: Sharing antiseizure medication (ASM) is underreported, even as it may significantly impact epilepsy outcomes, especially in access-limited settings. Factors leading to ASM sharing and its consequences among people with epilepsy in rural northwest India are explored. Methods: This exploratory study identified an index case of ASM sharing during a community-based intervention, and subsequently recruited additional participants through convenience sampling. Six participants (aged 19–65 years) were enrolled. We conducted clinical assessments, in-depth interviews using a modified medicine-sharing questionnaire, and trough serum ASM level testing. Data were analyzed descriptively and synthesized narratively. Results: Three participants borrowed ASMs, one lent them, and two borrowed and lent. Probable drivers included financial hardship, limited health care access, medicine stock-outs, stigma, perceived similarity of symptoms, and family influence on health care seeking. None of the consenting participants had serum ASM levels within the therapeutic range; three were subtherapeutic, and one was supratherapeutic. Conclusion: ASM sharing in low-resource communities is a unique health-seeking behavior that appears to be a coping response to stigma and systemic barriers, with potential serious clinical and psychosocial consequences. Efforts to address this practice should focus on improving medication access, raising awareness of epilepsy, and encouraging health care providers to address this issue during consultations. Publication History Article published online: 15 July 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Private Limited A-13A, Graphix Tower 1, 6th floor, Sector 62, Noida 201309, Uttar Pradesh, India