Health and economic benefits of public financing of epilepsy treatment in India: An agent‐based simulation model

Megiddo, Itamar; Colson, Abigail; Chisholm, Dan; Dua, Tarun; Nandi, Arindam; Laxminarayan, Ramanan

doi:10.1111/epi.13294

Cited by 166 publications

(95 citation statements)

References 30 publications

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“…A study conducted in India revealed that the cost per patient for epilepsy treatment was as high as 88.2% of the Indian's per capita gross national product (GNP). is epilepsy-related cost includes travel cost, lost work time, and medical costs which exceeded $2.6 billion/year [7].…”

Section: Introductionmentioning

confidence: 99%

Epilepsy Treatment Outcome and Its Predictors among Ambulatory Patients with Epilepsy at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Zewudie

Mamo

Feyissa

et al. 2020

Neurology Research International

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Background. Epilepsy is among the most common neurological disorders which is highly treatable with currently available antiepileptic drugs at a reasonable price. In Ethiopia, despite a number of studies revealed high prevalence of epilepsy, little is known on predictors of poorly controlled seizures. us, the aim of this study was to assess epilepsy treatment outcome and its predictors among patients with epilepsy on follow-up at the ambulatory care unit of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Methods. A hospital-based cross-sectional study involving patient interview and chart review was conducted from March 10 to April 10, 2018. Drug use patterns and sociodemographic data of the study participants were accustomed to descriptive statistics. Backward logistic regression analysis was done to identify predictors of poor seizure control. Statistical significance was considered at p value <0.05. Results. From a total of 143 studied patients with epilepsy, 60.8% had uncontrolled seizures. Monotherapy (79%) was commonly used for the treatment of seizures, of which phenobarbital was the most commonly utilized single anticonvulsant drug (62.9%). e majority (72.7%) of the patients had developed one or more antiepileptic-related adverse effects. Medium medication adherence (adjusted odds ratio (AOR) � 5.4; 95% CI � 1.52-19.23; p � 0.009), poor medication adherence (AOR � 8.16; 95% CI � 3.04-21.90; p � 0.001), head injury before seizure occurrence (AOR � 4.9; 95% CI � 1. 25-19.27; p � 0.02), and seizure attacks ≥4 episodes/week before AEDs initiation (AOR � 8.52; % CI � 2.41-13.45; p � 0.001) were the predictors of uncontrolled seizure. Conclusions. Based on our findings, more than half of the patients with epilepsy had poorly controlled seizures. Nonadherence to antiepileptic drugs, high frequency of seizure attack before AEDs initiation, and history of a head injury before the occurrence of seizure were predictors of uncontrolled seizure. Patient medication adherence should be increased by the free access of antiepileptic drugs and attention should be given for the patients with a history of head injury and high frequency of seizure attacks before AEDs initiation.

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Section: Introductionmentioning

confidence: 99%

Epilepsy Treatment Outcome and Its Predictors among Ambulatory Patients with Epilepsy at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Zewudie

Mamo

Feyissa

et al. 2020

Neurology Research International

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“…6 Epilepsy affects about 20-40 million people worldwide. 7 It is the second most common neurological disorder, after stroke. 8 The rates are similar between different ethnic groups and slightly higher for men compared to women.…”

Section: Introductionmentioning

confidence: 99%

Drug utilization pattern of antiepileptic agents among pediatric epilepsy at tertiary care teaching hospital of Gujarat: a cross sectional study

Dave¹,

Trivedi

2018

Int J Basic Clin Pharmacol

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Background: Epilepsy is one of the most common neurological disorders characterized by recurrent episodic paroxysmal involuntary clinical events associated with abnormal electrical activity from the neurons. Without the knowledge of how drugs are being prescribed and used, it is difficult to initiate discussion on rationale drug use and to suggest measures to change prescribing habits for the better management. Present study was performed with an aim to study the utilization pattern of anti-epileptic drugs (AEDs) for the paediatric patients suffering from various forms of epileptic seizures. Methods: The present cross-sectional study was conducted at the epilepsy clinic of Department of Paediatrics, Tertiary Care Teaching Hospital of Gujarat, on patients diagnosed to have epilepsy July 2014 to October 2014. Hundred Paediatric patients of either gender diagnosed to had epilepsy and taking treatment from pediatric epilepsy clinic OPD, S.S.G. Hospital, and Baroda. Patient's detailed medical history, demographic details and other required information was recorded on a prestructured data entry form. Results: Out of 100. GTCS was found to be the most common (55%) form of epilepsy among pediatric patients and Carbamazepine was the most commonly prescribed (41%) AED followed by sodium valproate (38%). 71% patients were prescribed monotherapy. Carbamazepine +Clobazam was the most commonly (7%) used combination. Conclusions: Use of appropriate AEDs in the majority of patients as per WHO guidelines, has decreased number of ADRs in this study.

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“…6 To overcome these issues, the development of effective and accessible antiepileptic drugs is needed.…”

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confidence: 99%

Protection Against Electroshock- and Pentylenetetrazol-induced Seizures by the Water Extract ofRehmannia glutinouscan be Mediated through GABA Receptor-chloride Channel Complexes

Kim

et al. 2017

Nat Prod Sci

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− Epilepsy is a brain disorder that affects millions of people worldwide. It is characterized by recurrent and unpredictable seizures that are usually controlled with antiepileptic/anticonvulsive drugs. However, most antiepileptic drugs produce various side effects such as tolerance and sedation. Thus, there is a growing interest for alternative anticonvulsive drugs, preferably from natural or herbal sources. In this study, we evaluated the anticonvulsive effects of Rehmannia glutinosa (RG). The anticonvulsive effect of RG extract was evaluated using electroshock-and chemical-induced seizure tests in mice. To identify its probable mechanism of action, the effects of RG extract on Cl − influx was measured in vitro. We found that RG extract has anticonvulsive effects against electroshock-induced seizures, as indicated by an increased seizure threshold in mice. The RG extract also decreased the percentage of seizure responses induced by the GABAergic antagonist, pentylenetetrazole. These results suggest that the anticonvulsive effects of RG extract are mediated through a GABAergic mechanism. In support of this mechanism, our in vitro test showed that RG extract increases intracellular Cl − influx. Furthermore, RG extract did not show sedative and/or muscle relaxant effects in the open-field and rota-rod tests. Altogether, these results confirm that RG extract could be a herbal anticonvulsant and a potential alternative for clinical use.

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Health and economic benefits of public financing of epilepsy treatment in India: An agent‐based simulation model

Cited by 166 publications

References 30 publications

Epilepsy Treatment Outcome and Its Predictors among Ambulatory Patients with Epilepsy at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Epilepsy Treatment Outcome and Its Predictors among Ambulatory Patients with Epilepsy at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Drug utilization pattern of antiepileptic agents among pediatric epilepsy at tertiary care teaching hospital of Gujarat: a cross sectional study

Protection Against Electroshock- and Pentylenetetrazol-induced Seizures by the Water Extract ofRehmannia glutinouscan be Mediated through GABA Receptor-chloride Channel Complexes

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