Assessing the pharmaceutical care issues of hospitalised epileptic patients

Studies concerning epilepsy in the context of Pharmaceutical Care in Malaysia are lacking. Thus, this study aims to determine the issues on hospitalised epileptic patients prescribed on anti-epileptic drugs (AED. Factors associated with uncontrolled seizure and hospitalisation and the drug related problems (DRP) encountered were described. Adult epileptic patients were screened and those fulfilling the inclusion criteria were recruited. These patients must be confirmed cases of epilepsy and on AED’s for at least two months. The results showed 56.9% of patients’ defaulted AED doses prior to the seizure attack. The remaining 43.1% of the patients were affected by emotional stress, fever, weather and alcohol. The DRPs identified were non-adherence towards medication (64.6%), dose inadequacy (51.9%, inappropriate drugs of choice with respect to specific indication (35%), underreporting of adverse effects (76.2%), underutilisation of Therapeutic Drug Monitoring services (41.5%) and inappropriateness of therapy of patients with liver diseases. Nevertheless, medication adherence was found to be the major factor for uncontrolled epilepsy (OR= 7.06, CI= 1.29-38.56, P = 0.019). Among the non-adherers, only 19% received medication counselling upon discharge (P = 0.043). In summary, pharmacists are needed to address the mentioned DRPs so as to optimize drug therapy in achieving the desired treatment goal.