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Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna

2026-01-01T00:00:00Z

Title: Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna Authors: Thenuka, K.; Kalki, P.; Nilukshika, U.; Saranja, N.; Sanchayan, K. Abstract: Epilepsy affects both adults and children and requires long-term medication control, with antiepileptic drugs as the first-line therapy. Good adherence to anti-epileptic medication (AEM) is essential for optimal treatment outcomes, particularly in children who may not require lifelong treatment. Caregiver awareness and knowledge play a critical role, as non-adherence to AEM has become a significant concern. This hospital-based descriptive cross-sectional study aimed to assess caregiver knowledge and medication adherence among caregivers of children with epilepsy attending the Paediatric Clinic at Teaching Hospital Jaffna. A total of 127 caregivers aged over 18 years, caring for children under 14 years with epilepsy, participated in the study, with a response rate of 97%. Data were collected using a knowledge questionnaire (score range: 0–13), numerical, and the MARS-5 (Parent Version) adherence scale (score range: 6–30), categorized into good and poor adherence. Statistical analysis included Chisquare or Fisher’s exact tests, Mann–Whitney U, and Kruskal–Wallis tests, with significance set at p ≤ 0.05. Most caregivers were parents (96%). The mean caregiver knowledge score was moderate (8.43/13). Good adherence was significantly associated with higher knowledge scores, regular clinic attendance, fewer seizure episodes, family history of epilepsy, parental factors, and awareness of medication side effects. Higher knowledge levels were associated with being married, having a middle household income, a better understanding of epilepsy, and awareness of AEM side effects. The findings highlight the need for ongoing caregiver education and consistent support from healthcare professionals to ensure effective epilepsy management in children.

Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka

2026-01-01T00:00:00Z

Title: Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka Authors: Guruparan, Y.; Thiyahiny, S.N.; Kumar, R.; Gowry, S.; Shalini, S.R. Abstract: Objectives This study explores perceptions of inhaled medications among patients with asthma at an outpatient tertiary care setting in Northern Sri Lanka. Design A descriptive qualitative research design was used to gather data through focus group discussions (FGDs) that were transcribed, translated, manually coded and thematically analysed using Braun and Clarke’s six-step approach. Setting The study was conducted at an outpatient medical clinic at a tertiary care centre in Northern Sri Lanka. Participants Six FGDs were carried out among adult patients with asthma who had been on inhaled medications for at least 3 months. Participants were selected by maximum variation sampling, with each FGD consisting of 6–10 participants. Results 51 participants between the ages of 20 and 71 years were recruited; 36 (70.6%) were female, and about a fourth had primary education or less. Seven subthemes were drawn out and organised into three overarching themes: (1) inhaler hesitancy; (2) fear-driven adherence and (3) conviction at last. Most participants were initially reluctant to use inhalers, primarily due to concerns about dependency and side effects, often influenced by opinions of family members. They delayed use until they experienced severe symptoms, with some describing nebulisation, hospitalisation and fear of death as turning points. Symptom alleviation and improved quality of life led to better adherence. Conclusions Delays in inhaler use could lead to poor asthma control and outcomes. As many patients reported using their inhalers more consistently after an exacerbation or hospitalisation, asthma education programmes, involving both patients and family members, could address context-specific beliefs and misconceptions to promote early and sustained adherence to inhaled medications.

Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data

2024-01-01T00:00:00Z

Title: Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data Authors: Thiyahiny, S.N.; Gajanthan, R.; Janahan, R.; Sujanitha, V.; Sivansuthan, S.; Kesavan, R. Abstract: Abnormal lipid profile is considered as an important contributor to cardiovascular diseases among South Asians. Sri Lanka is a multiethnic South Asian nation and differences in ethnicity may influence the pattern of lipid profile. The aim of this paper is to analyse the lipid levels of healthy adults of a predominantly Sri Lankan Tamil population in the Northern Sri Lanka and compare it with the lipid levels of different ethnic groups reported in the literature. It was a cross-sectional analysis of secondary data of 500 healthy adults who were the controls of a larger study on the lipid profile of diabetic and non-diabetic patients. Cut-off values for desirable lipid levels used in this study were determined according to national and international guidelines. Chi-squared test, independent t-test/ Mann– Whitney U-test and one-way analysis of variance were used to determine the statistical significance and a p-value <0.05 was considered significant. The majority (61.4%) were women and the mean age was 54.8±12.6 years. Mean lipid levels were within normal range except HDL cholesterol (HDL-C) in women (46.6± ±10.6 mg/dL). Desirable lipid levels were observed in majority of the participants (58%- 80%) except HDL-C among women (32%). Half of the study population had a desirable total cholesterol: HDL-C ratio (50.8%). Significant difference between men and women was observed for HDL-C (p<0.05). The HDL-C levels and total cholesterol: HDL-C ratio of Jaffna population were comparable to those of South Asian populations. Further studies are needed to determine the clinical implication of these observations.

Effectiveness of inhaled therapies in asthma among adults in Northern Sri Lanka, a low-income and middle-income country: a prospective observational study

2025-01-01T00:00:00Z

Title: Effectiveness of inhaled therapies in asthma among adults in Northern Sri Lanka, a low-income and middle-income country: a prospective observational study Authors: Guruparan, Y.; Thiyahiny, S.N.; Gowry, S.; Shalini, S.R. Abstract: Background Inhaled corticosteroids (ICS) alone, or combined with long-acting beta2-agonist (LABA), are recommended for chronic asthma. Limited access to inhaled medications hinders effective control of asthma in low-income and middle-income countries. Objective This study aimed to compare the effectiveness of inhaled therapies in a cohort of adult patients with asthma who were receiving treatment in a tertiary hospital in Northern Sri Lanka. Methods A prospective cohort study was conducted among adult patients with asthma on either ICS alone or ICS/LABA combination for at least 3 months. Participants were followed up for 6 months, with two follow-up interviews conducted 3 months apart. The primary outcome measure was asthma control, assessed by a locally validated asthma control patient-reported outcome measure. Secondary outcome measures included the use of short-acting beta2-agonists (SABA) and the percentage of patients required nebulisations and hospitalisations. McNemar’s test was used to determine the statistical significance. A p value≤0.05 was considered significant. Results Of the 1094 participants, 827 (76%) were on ICS monotherapy and 267 (24%) were on ICS/LABA. Though there were no changes in the treatment, progressive improvement in asthma control was observed from baseline to second follow-up in both ICS (54%–72%) and ICS/LABA (76%–81%) groups. Significant improvement in asthma control (p<0.001) and SABA overuse (p<0.001) at both follow-ups and nebulisation (0.008) at the first follow-up were observed in the ICS group. Conclusion Both ICS monotherapy and ICS/LABA were effective in controlling asthma. Though control was greater with ICS/LABA, the effect of additional monitoring during the follow-up was higher and significant in ICS monotherapy. Considering the low access to ICS/ LABA, a treatment package comprising ICS plus non-pharmacological approaches could be a more realistic and cost-effective treatment strategy in the local context. ICS/ LABA could be reserved for patients who fail to respond. However, this observation needs to be confirmed by interventional studies.