Assessment of Drug Therapy Problems among Ambulatory Epileptic Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2018-03
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Addis Ababa Universty
Abstract
Assessment of Drug Therapy Problems among Ambulatory Epileptic Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Beshir Bedru
Addis Ababa University, 2018
About 90% of epileptic patients in developing countries are not receiving appropriate treatment due to different reasons. Recurrence and breakthrough seizures can be caused by both drug and non-drug related problems such as inadequate or suboptimal antiepileptic regimens, adverse reaction and poor adherence. This may lead to reduced quality of life, increased overall health care cost and increased risk of morbidity and mortality. Management of epilepsy especially in developing country is challenging and drug therapy problems (DTPs) and poor medication adherence might be the major reasons. There is limited evidence regarding DTPs in epileptic patients thus this study aimed to asses DTPs and medication adherence among ambulatory epileptic patients at Tikur Anbessa Specialized Hospital (TASH). A hospital based cross sectional study was conducted on 291 epileptic patients who had follow up at TASH. Data collection was done through patient interview and medical charts review. Epi Info7.2.1 was used for data entry and data was analysed using SPSS version 21. Descriptive statistics, cross-tabulation, binary and multiple logistic regressions were utilized and P < 0.05 was used to declare association. Phenobarbital (67%) and phenytoin (33.3%) were among the frequently prescribed antiepileptic drugs both as monotherapy and combination therapy and only (18.6%) of the study participants had controlled seizure. DTP was found in 70.4 % of the study participants. Adverse drug reaction (41.5%) was the top DTPs identified followed by ineffective drugs (27.8%), drug interaction (12.8%) and inappropriate dose (11.9%). Headache, depression and epigastric pain were frequently reported adverse drug reaction. Carbamazepine was involved in majority of the drug interaction and phenobarbital in inappropriate dose (dose too high). The rate of medication adherence was 57.3% and the common reasons for non-adherence were forgetfulness, medication unavailability and fear of side effects. Number of medications taken by the patients had a significant association with occurrence of DTPs, whereas source of medication and seizure free periods were found to have significant association with poor adherence. Prevalence of DTPs among ambulatory epileptic patients was high and about half of the patients were non adherent for their medication.
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Drug Therapy Problems, Epilepsy, Tikur Anbessa Specialized Hospital