Assessing the pharmaceutical care issues of antiepileptic drug therapy in hospitalised epileptic patients

Abstract

Background Studies concerning epilepsy in the context of pharmaceutical care in Malaysia are lacking. Optimal pharmacotherapy management is necessary to achieve good seizure control. Aim To determine the pharmaceutical care issues in hospitalised epileptic patients. The factors associated with uncontrolled seizure and hospitalisation and the drug-related problems encountered are also described. Methods A cross-sectional study was conducted on 65 hospitalised epileptic patients until discharge. Prediction of dose adequacy and adherence, assessment of drug-related problems, adherence and outcome measurement of seizure control were analysed. Results Overall, 56.9% of patients defaulted from antiepileptic drug doses prior to seizure attack. The remaining 43.1% were affected by emotional stress, fever, weather and alcohol. The drug-related problems identified were non-adherence to medication (64.6%), dose inadequacy (51.9%), under-reporting of adverse effects (76.2%), under-utilisation of therapeutic drug monitoring services (41.5%) and inappropriateness of therapy in patients with liver disease. Nevertheless, medication adherence was found to be the major factor for uncontrolled epilepsy (odds ratio = 7.06, confidence interval = 1.29–38.56, p = 0.019). Among the non-adherers, only 19% received medication counselling upon discharge (p = 0.043). Conclusion Pharmacists need to address the drug-related problems in order to optimise drug therapy and achieve the desired treatment goal.