Nasir Beshir Bedru, Yifru Yared Mamushet, Engidawork Ephrem, Gebrewold Meron Awraris, Woldu Minyahil Alebachew, Berha Alemseged Beyene
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University (AAU), Addis Ababa, Ethiopia.
Department of Neurology, School of Medicine, College of Health Sciences, AAU, Addis Ababa, Ethiopia.
Patient Relat Outcome Meas. 2020 Apr 21;11:119-127. doi: 10.2147/PROM.S243867. eCollection 2020.
Anti-epileptic drugs (AEDs) are the primary therapeutic modalities for epilepsy management. However, one-third of epileptic patients continue to experience seizure even with appropriate AED use. Patients with epilepsy are at increased risk for seizure-related injury and they have higher incidences of home, street and work accidents. There is a paucity of data on AED use pattern and treatment outcomes among patients with epilepsy in the tertiary hospitals of Ethiopia. Therefore, the aim of this study was to assess AED use pattern, treatment outcome, and prevalence of seizure-related injury among patients with epilepsy in Tikur Anbessa specialized Hospital (TASH), Ethiopia.
An institution-based cross-sectional study was carried out on 291 patients with epilepsy attending the neurology clinic of TASH. A semi-structured questionnaire and data abstraction format were used to collect data through patient interview and medical chart review. Binary logistic regression was utilized to identify the associated factors of treatment outcome.
About 172 (59%) of the patients were taking a single AED, in which phenobarbital, 195 (67%), and phenytoin, 97 (33.3%), were the most frequently prescribed AEDs as monotherapy and combination therapy. Headache, depressed mood and epigastric pain were frequently reported as adverse drug reactions. Seizure-related injury was reported among 78 (26.8%) patients and head injury 15 (5.2%), desntal injury 15 (5.2%), soft tissue injury 14 (4.8%) and burns 10 (3.4%) were the commonest. About two-thirds (191, 65.6%) of the study participants had uncontrolled seizure. Medication adherence and multiple AEDs were significantly associated with treatment outcome.
All the study participants were put on old generation AEDs with phenobarbital being the most frequently used. About two-thirds of the patients had uncontrolled seizure and seizure-related injury is still a serious concern among patients with epilepsy.
抗癫痫药物（AEDs）是癫痫治疗的主要方式。然而，即使合理使用AEDs，仍有三分之一的癫痫患者会继续发作。癫痫患者发生与癫痫发作相关损伤的风险增加，在家中、街道和工作场所发生事故的发生率更高。埃塞俄比亚三级医院中癫痫患者使用AEDs的模式及治疗效果的数据匮乏。因此，本研究旨在评估埃塞俄比亚提库尔·安贝萨专科医院（TASH）癫痫患者的AEDs使用模式、治疗效果以及与癫痫发作相关损伤的患病率。
对在TASH神经科门诊就诊的291例癫痫患者进行了一项基于机构的横断面研究。通过患者访谈和病历审查，使用半结构化问卷和数据提取格式收集数据。采用二元逻辑回归来确定治疗效果的相关因素。
约172例（59%）患者服用单一AED，其中苯巴比妥195例（67%）和苯妥英97例（33.3%）是单药治疗和联合治疗中最常处方的AEDs。头痛、情绪低落和上腹部疼痛是最常报告的药物不良反应。78例（26.8%）患者报告有与癫痫发作相关的损伤，其中头部损伤15例（5.2%）、牙齿损伤15例（5.2%）、软组织损伤14例（4.8%）和烧伤10例（3.4%）最为常见。约三分之二（191例，65.6%）的研究参与者癫痫发作未得到控制。服药依从性和多种AEDs与治疗效果显著相关。
所有研究参与者均使用老一代AEDs，其中苯巴比妥使用最为频繁。约三分之二的患者癫痫发作未得到控制，癫痫发作相关损伤仍是癫痫患者的一个严重问题。
