Correlation between Distance from Health Centre and Adherence to Clinic Appointments and Medication Procurement among People with Epilepsy in the Community

Introduction: In resource limited countries (e.g., India), distance from the health care facility may be a barrier to treatment adherence in people with epilepsy.

Objective: To study the relationship between Euclidean distance of home dwelling from the health care center and number of health center visits to procure medication and medical advice by people with epilepsy.

Methods: The setting of the study was a community-based project in which subjects from across the Ludhiana city in one arm visited the civil hospital on a monthly basis for consultation and to procure antiepileptic drugs. We mapped out the homes of people with epilepsy who attended the epilepsy clinic and calculated the Euclidean distance between each home and the civil hospital. We studied the association between clinic visits and the distance factor; age, gender, educational and economic status, and duration of epilepsy as covariates.

Results: The mean distance between home and hospital was 3.33 ± 0.18 km. The average calculated cost of antiepileptic drugs per month was Rs.303 only. We could not establish a direct correlation between the distance and adherence (p-value = 0.74), although socioeconomic status (p = 0.175) and gender (p = 0.113) were associated with adherence.

Conclusion: The study is ongoing and although at this stage a correlation between distance and clinic visits could not be established, longer follow-up may demonstrate the distance decay effect.