Zewudie Ameha, Mamo Yitagesu, Feyissa Desalegn, Yimam Mohammed, Mekonen Gosaye, Abdela Ahmed
Department of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
Department of Pharmacy, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia.
Neurol Res Int. 2020 Apr 8;2020:8109858. doi: 10.1155/2020/8109858. eCollection 2020.
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. Thus, 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.
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 value <0.05.
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%). The 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; =0.009), poor medication adherence (AOR = 8.16; 95% CI = 3.04-21.90; =0.001), head injury before seizure occurrence (AOR = 4.9; 95% CI = 1.25-19.27; =0.02), and seizure attacks ≥4 episodes/week before AEDs initiation (AOR = 8.52; % CI = 2.41-13.45; =0.001) were the predictors of uncontrolled seizure.
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.
癫痫是最常见的神经系统疾病之一，目前可用的抗癫痫药物以合理的价格就能对其进行有效治疗。在埃塞俄比亚，尽管多项研究表明癫痫的患病率很高，但对于癫痫发作控制不佳的预测因素却知之甚少。因此，本研究的目的是评估埃塞俄比亚西南部米赞 - 泰皮大学教学医院门诊护理单元接受随访的癫痫患者的癫痫治疗结果及其预测因素。
2018年3月10日至4月10日进行了一项基于医院的横断面研究，包括患者访谈和病历审查。研究参与者的用药模式和社会人口统计学数据采用描述性统计方法。采用向后逻辑回归分析来确定癫痫发作控制不佳的预测因素。当P值<0.05时认为具有统计学意义。
在总共143例接受研究的癫痫患者中，60.8%的患者癫痫发作未得到控制。单药治疗（79%）是常用的癫痫治疗方法，其中苯巴比妥是最常用的单一抗惊厥药物（62.9%）。大多数患者（72.7%）出现了一种或多种与抗癫痫药物相关的不良反应。中等药物依从性（调整比值比（AOR）=5.4；95%置信区间（CI）=1.52 - 19.23；P=0.009）、差的药物依从性（AOR=8.16；95%CI=3.04 - 21.90；P=0.001）、癫痫发作前头部受伤（AOR=4.9；95%CI=1.25 - 19.27；P=0.02）以及在开始使用抗癫痫药物之前癫痫发作≥4次/周（AOR=8.52；95%CI=2.41 - 13.45；P=0.001）是癫痫发作未得到控制的预测因素。
根据我们的研究结果，超过一半的癫痫患者癫痫发作控制不佳。不坚持服用抗癫痫药物、在开始使用抗癫痫药物之前癫痫发作频率高以及癫痫发作前有头部受伤史是癫痫发作未得到控制的预测因素。应通过免费提供抗癫痫药物来提高患者的药物依从性，并且应对有头部受伤史以及在开始使用抗癫痫药物之前癫痫发作频率高的患者给予关注。
