Abstract
Background: There is an evidence of diverse patterns of drug utilization of antiepileptic drugs in our country. Newer drugs are becoming available now and how these drugs are utilized is very interesting to see. Problems in antiepileptic therapy like use of polytherapy, adverse drug reactions, lack of adherence to medications etc., can be identified and resolved by clinical pharmacist. Considering all these facts we started study with title “To Study of Drug Utilization Review in Epileptic Patients”.
Materials and Methods: Prospective observational study of 6 months duration was carried out after human ethics research committee approval. All in-patients and outpatients who had epilepsy and prescribed with anti-epileptic drugs in neurology department were selected. Data were collected in customized data collection form after taking patient consent and also from patient case sheets/prescriptions. The data collection tool used for the study was a validated self-prepared questionnaire to assess the Drug Utilization Review and other objectives. Among the people with epilepsy, Data were measured in percentage and frequency using descriptive statistics. Microsoft excel was used to summarize the analysis of data. Chi –square test, t-test and Annova test was used.
Results: A total of 100 patients enrolled to study where 197 antiepileptic drugs were prescribed. The majority of patients belonged to age group 11-20 year (34%) followed by the age group 21-30 year (24%) The mean age of the participant was 25yrs. There were 56% male in sample and 44% female. In this study 24% patients with symptomatic epilepsy and idiopathic generalized epilepsy was 12 %. Prescription pattern of drugs showed that clobazam 31% was the most common drug used either as single, dual or in combination with other drugs to treat epilepsy. Mostly dual therapy (56%) was used to treat the patients. (22%) prescriptions for newer compared to older generation antiepileptic’s. Variations of Sum-of- squares within the treatment i.e., between mono, dual and poly therapy is much more compare to the variations between the disease types and conditions. Hence, the newer prescribed anti-epileptic drugs shows the remarkable superior variables on account of low ADR compare to older anti-epileptic drugs. Majority of sample were compliant and never miss their medication (73%), only 10 patients was irregular in taking antiepileptic drugs and antiepileptic drug compliance. The study showed that there was no relationship between AED compliance these include patient age, gender, duration of illness, adverse drug reaction, type of therapy, and frequency of take medicine. By chi –square test. A significant relationship was found between age (0.0428), adverse drug reaction (p=0.05). Drug related problems were drug interaction (29.10%) followed by medication error (29%), adverse drug reaction (14%), untreated conditions (13.6), wrong dose (13).We counselled these patients.
Conclusion: Very less new antiepileptic drugs were used with high evidence of dual therapy. Clobazam was the most commonly prescribed drug. Clinical pharmacist mediated services helped to identify and reduce drug therapy related problems. Majority of patients found Drug compliance
Keywords: Antiepileptic drug, prescribing pattern, polytherapy, drug interaction, Drug compliance.
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Corresponding Author
Juhi Singh
Research Scholar, Department of Pharmacy Teerthanker Mahaveer College of Pharmacy
NH24 Moradabad, Uttar Pradesh, India