A Cross-sectional Observational Study to Find out the Pattern of Drug Utilization and Medication Adherence of Anti-Epileptic Drugs (AEDs) among Epileptic Patients at a Tertiary Care Teaching Hospital

Abstract

Background: Antiepileptic drugs (AEDs) are the mainstay of the therapy for epilepsy, despite the development in recent years of new therapeutic options, such as brain stimulation or Surgery. Objective: To understand the pattern of drug utilization and medication adherence of anti-epileptic drugs (AEDs) among epileptic patients at a tertiary care teaching hospital.
 Methodology: A cross-sectional observational study of a total of 120 subjects receiving anti-epileptics was done. All the patients with epilepsy were prescribed with anti-epileptic drug who visited, admitted, or referred to the Department of Neurology. All inpatients and outpatients of epilepsy were screened for the study.
 Results: A total of 120 patients were included in our study into which (38.33%) were inpatients and (61.67%) were outpatient. The male (56%) patients were more as compared to female (44%) patients. A maximum number of patients were from the age group of 21-40 (41%) year. The majority of the patient were suffered from focal epilepsy (63%), remaining were having a generalized seizure. The highest comorbidities were found to be HTN and diabetes mellitus. Monotherapy was highly prescribed as compare to polytherapy. Among single AED, the maximum prescribed drug was Carbamazepine [30% (N=17)] followed by 25% (N=14) of phenytoin and levetiracetam 21% (N=12). In two AED Combinations, the most prescribed drugs were clobazam + Levetiracetam and Midazolam + phenytoin 12% (N=5) followed by sodium valproate + clobazam 10% (N=4). Highest combination of three AEDs that were prescribed the highest were carbamazepine + Levetiracetam + clobazam and phenytoin + phenobarbitone + sodium Valproate 20% (N=2)
 The highest medication adherence was found in patients who were on single AEDs and the lowest adherence was found in the patients who were on more than two AEDs.
 Conclusion: Antiepileptic drug monotherapy was highly prescribed as compare to polytherapy. Phenytoin was the most commonly prescribed AEDs followed by carbamazepine and highly prescribed single AEDs were found to be carbamazepine. The patients who were on single epileptic drugs showed the highest adherence as compared to the patients with more than two AEDs.