Article Text
Abstract
Background Epilepsy may need chronic medical treatment throughout life. This is why, besides epileptologists, clinical pharmacists also have an important role in the evaluation of effectiveness, tolerability, side effect, drug interaction, teratogenicity of antiepileptic drugs (AEs).
Purpose To investigate how the cooperation of epileptologists and clinical pharmacists influence compliance and the effect of AEs on the quality of life.
Materials and Methods We analysed 60 parameters of 1845 adult outpatients with epilepsy in the Eastern-Hungarian Database at the Department of Neurology, between 1992–2011. The clinical pharmacist collected and analysed data from 1015 men and 830 women that were related to epilepsy treatment. For statistical analysis the ‘STATISTICS for Windows’ programme was used.
Results The mean age was 49.3 years. Seventy-seven patients had idiopathic and 1768 symptomatic or cryptogenic epilepsy. During the examination period 1517 patients took antiepileptic treatment: 71% monotherapy, 21% dual therapy and only 8% polytherapy. Thirty-eight percent of the patients were on carbamazepine and 14% valproate monotherapy. Seventeen percent of the patients were seizure-free on levetiracetam, lamotrigine or oxcarbazepine monotherapy at least for one year. The ratio of side effect was 7.6%. Eighty-eight patients gave birth, 70 of whom took AEs during the organogenesis. No minor or major developmental disorders were observed, although there was one spontaneous miscarriage. At the start of the study a surprisingly high proportion of the patients (36.2%) received concomitant treatment affecting the CNS that could also influence the AEs metabolism. After carefully analysing the patient’s history and symptoms, we could decrease the use of the co-medication (diazepam, antidepressants, minor and major tranquillisers, alprazolam) to 14.6% of the patients. The compliance was good in 78.7% of the patients.
Conclusions The data of Epilepsy Database analysis may give useful information in clinical practise, not only for epileptologists but clinical pharmacists too. Individuall-planned monotherapy decreases the side effects and improves the quality of life in patients with epilepsy.
No conflict of interest.