Treatment outcome and associated factors among patients with epilepsy

Abstract

Epilepsy is a major public health problem worldwide. Despite multiple drug therapies, people with epilepsy continue to have frequent seizures. There is a dearth of data on epilepsy treatment outcome and associated factors in our setting. Therefore, the aim of this was to assess treatment outcome and associated factors among epileptic patients on follow up at the neurologic clinic of Ayder comprehensive specialized hospital, Ethiopia. A cross-sectional study was conducted on randomly selected epileptic patients. Data were collected through patient interview and review of medical records. Epilepsy treatment outcome was evaluated in terms of seizure control status in the last one year follow up period. Binary logistic regression analysis was performed to identify predictors of treatment outcome. A total of 270 patients were included. Of whom, 46.6% had controlled seizures. Whereas, 38.5%, 8.8%, and 5.9% had experienced seizure attacks 1–5 times, 6–10 times, and greater than 10 times, respectively. Alcohol consumption [adjusted odds ratio [(AOR): 14.87, 95% confidence interval (CI): 3.25–68.11], negative medication belief [AOR: 3.0, 95%CI: 1.31–6.71], low medication adherence [AOR:11.52, 95%CI: 3.25–40.82], and presence of comorbidities [AOR: 10.35, 95%CI: 4.40–24.40] were predictors of uncontrolled seizure. Our finding revealed that more than half of the epileptic patients had uncontrolled seizure. Epileptic patients with a negative medication belief, comorbidities, low medication adherence, and those who consume alcohol were more likely to have uncontrolled seizure. Therefore, more emphasis should be given to these patients.

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

“…e result of this study showed that low medication adherence was an independent predictor of uncontrolled seizures. is is in line with the studies done in Gonder and Mekelle, Ethiopia [18,24]. In addition, this study showed that high adherence to AEDs decreases the risk of seizure attacks [27].…”

“…In this study, the most commonly diagnosed comorbidity among studied patients with epilepsy was found to be a psychiatric condition (13.3%). is is similar to the study done in the USA (33.7%) and Mekelle, Ethiopia (20.37%) where the psychiatric condition was the most common comorbidity [24,25].…”

“…is is higher than the studies done in Mekelle and Ambo, Ethiopia, where 43.3% and 41.7% of patients experienced AEDs-related adverse effects, respectively [24,26]. e discrepancy might be due to the fact that, in the current study, some of the patients were diagnosed with an unclassified type of seizures which might result in incorrect dose, frequency, drug selection, and drug interaction which in turn cause adverse drug effects.…”

“…e reason could be the difference in the duration of the outcome measurement report, which was short in the previous study. For instance, the study done in Gonder and Mekele measured the treatment outcome after the patients took AEDs for 3 months and 1 year, respectively [18,24]. But, in the current study, the status of seizure was measured for the epileptic patients on AEDs for at least 24 months.…”

Health-related quality of life and its determinants among ambulatory patients with epilepsy at Ambo General Hospital, Ethiopia: Using WHOQOL-BREF

“…Some of the contributing factors for poor HRQOL in PWE were: un-controlled seizure, high prevalence of psychiatric disorder (depression and anxiety) [22,23], old age, different socio-demographic factors, Poly-pharmacy [14,17,[24][25][26][27] and being chronic disease [19]. In addition, a high rate of uncontrolled seizure in LMICs (up to 64.4%) [28][29][30] than high-income countries (up to 36.3%) [31] may be contributing factors for poor HRQOL in this population.…”