Drug therapy problems and treatment satisfaction among ambulatory patients with epilepsy in a specialized hospital in Ethiopia

Abstract

Objective Epilepsy management especially in developing country is challenging. Seizures recurrence can be caused by both drug and non-drug related problems such as inadequate antiepileptic regimens, adverse drug reaction and poor adherence. Patient treatment satisfaction also affects the treatment out comes by improving medication adherence. This study aimed to assess drug therapy problems (DTPs) and treatment satisfaction among ambulatory epileptic patients at Tikur Anbessa Specialized Hospital. Methods A prospective cross-sectional study was conducted on 291 epileptic patients. Data was collected through patient interview and medical charts review. DTPs were identified based on the standard treatment guidelines and Micromedex® was used as drug interaction checker. Cipolle DTPs classification was used to classify the DTPs and Treatment Satisfaction with Medicine Questionnaire (SATMED-Q) was used to assess treatment satisfaction. Binary logistic regressions were utilized to identify the associated factors. Results Phenobarbital 195 (67%) and phenytoin 97 (33.3%) were the most frequently prescribed antiepileptic medications as monotherapy or combination therapy. Only 54 (18.6%) of the study participants had controlled seizure. DTP was found in 205(70.4%) of the study participants. From 352 DTPs identified, adverse drug reaction 146 (41.5%) was the leading DTPs followed by ineffective drugs 98 (27.8%) drug interaction 45 (12.8%) and inappropriate dose 42(11.9%). Headache, depression and epigastric pain were frequently reported adverse drug reaction. Among the study participants 167 (57.3%) were adherent to their medications. The number of medications taken by the patients had significant association with occurrence of DTPs, whereas source of medication and seizure free periods were found to have significant association with poor adherence. The global patient satisfaction was

Medication‐related problems and adverse drug reactions in Ethiopia: A systematic review

“…The number of study participants varied from a smaller prospective study of 97 patients 15 to a larger retrospective study involving 3921 study participants 16 . The oldest study was published in 2012, 17 while the most recent was in 2020 18 . Twenty‐four studies were conducted on MRPs, of which 15 studies were conducted in a specific patient population, and the remaining were conducted among general/nonspecific patient populations 19‐26 .…”

“…In addition, two‐thirds of the studies used prospective designs except for Haymen et al, 27 Yohanes et al, 28 Abadir et al, 39 and Hailu et al 29 studies. More than half (n = 10) of the included studies investigated one or more cardiovascular disease conditions, 15,28,32,35,36,39‐42 while Gebre et al, 43 Aster et al 44 and Beshir et al 18 studied ambulatory diabetic patients, hospitalized chronic kidney disease patients, and ambulatory epileptic patients, respectively. Moreover, Haymen et al 27 and Hailu et al 29 targeted ambulatory type II diabetes mellitus patients.…”

“…Moreover, Haymen et al 27 and Hailu et al 29 targeted ambulatory type II diabetes mellitus patients. Only two studies, Mohammednur et al 41 and Beshir et al, 18 reported clinical outcomes of MRPs (Table 2). Further, seven studies 27‐29,42‐45 reported the specific causative agents (drugs) responsible for MRPs.…”

“…Considering disease‐related variables, the number of diagnoses 24,35 and presence of comorbidity 29,32,39,40,44 in specific patients were the commonly identified risk factors of MRPs. In addition, the number of drugs in both nonspecific 20‐22,24,25,35 and specific patients 18,29,36,39,41,42,44 were the frequently reported risk factor of MRPs, while taking zidovudine regimen 16,33,47 was the frequent risk factor of ADRs.…”

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

“…Our study found a great proportion of admissions with DRPs, a 45.1% of the cases. Most of the evidence available at a hospital level have focused on specific medical fields [51][52][53] , being limited to ambulatory patients in numerous occasions [54][55][56] . There are, however, some studies focusing on medical specialties, which found a DRP prevalence ranging from 15 to 81% 26,27,[60][61][62] .…”