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Individual level analysis modeled the relationships between ASM adherence with seizure occurrence, as well as with a simplified seizure forecast via a 90\u2010day moving average (\u201cNapkin method\u201d). Group\u2010level analysis with a mixed\u2010effects model was performed to examine the relationship between ASM adherence and simplified forecasts, while controlling for differences in individual seizure frequency via random effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010seven participants (median age\u2009=\u200929\u2009years) contributed 7,853 person\u2010days. Individual analysis showed that only a small (n\u2009=\u20092) number of participants had a weak relationship between ASM adherence with seizure occurrence. Group\u2010level analysis showed that seizure occurrence was highly linked to the Napkin method, but not ASM adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Among individuals with frequent, drug\u2010resistant epilepsy, occasional missed ASM doses did not measurably raise immediate seizure risk. Whereas sustained nonadherence remains a clinical concern, clinicians may reassure patients that infrequent brief lapses are unlikely to trigger seizures acutely, yet they should continue emphasizing overall adherence for long\u2010term seizure control. 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