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.
PLoS One. 2024 Feb 26;19(2):e0299065. doi: 10.1371/journal.pone.0299065. eCollection 2024.
The world continues to be challenged by the Coronavirus disease 2019 (COVID-19) and preventive measures like maintaining social distancing and lockdowns challenge patients to attend regular follow-ups and get a refill for medication that causes adherence problems. Hence, this study attempts to assess the impact of COVID-19 on treatment follow-up and medication adherence among patients with epilepsy.
A total of 276 patients with epilepsy were enrolled in the study. Data collection was carried out through medical record reviews and patient interviews. Patients who visited Zewditu Memorial Hospital from August to September 2021 and those who had follow-up at least for two years before the outbreak of the pandemic were included. The data was analyzed using SPSS v.24.
About 69.6% of patients were adherent to their treatment and 83.3% of the patients had a seizure-free period of less than 1 year. Ninety (32.6%) of the participants missed their treatment follow-up during the pandemic, mainly due to fear of being infected with COVID-19. Sixty-eight (24.6%) patients have experienced increased seizure episodes during the pandemic as compared to the previous times. Moreover, 56 (20.3%) participants were not taking their antiseizure medications (ASMs) during the pandemic because of the unavailability of medications and they discontinued hospital visits for their medication refills. Among those who missed their treatment follow-up, 20% had seizure-related physical injuries. Only educational level has a significant association with visiting health facilities during the pandemic. Thus, participants who completed college and above (OR = 2.58, 95% CI (1.32-6.38)) were more likely to attend their follow-up during the pandemics as compared to participants who can't read and write.
The present study revealed that COVID-19 might have impacts on treatment follow-up and medication adherence due to fear of infection, travel restrictions and the indirect impact on the availability and affordability of medications. These might lead to poor treatment outcomes like increased seizure frequency and seizure-related physical injuries.
全球仍在受到 2019 年冠状病毒病（COVID-19）的挑战，保持社交距离和封锁等预防措施使患者难以定期进行随访和药物续配，从而导致用药依从性问题。因此，本研究试图评估 COVID-19 对癫痫患者治疗随访和药物依从性的影响。
共纳入 276 例癫痫患者。通过病历回顾和患者访谈进行数据收集。纳入标准为 2021 年 8 月至 9 月期间就诊于泽维图纪念医院且在大流行爆发前至少有两年随访记录的患者。采用 SPSS v.24 进行数据分析。
约 69.6%的患者治疗依从性良好，83.3%的患者无癫痫发作期少于 1 年。90（32.6%）名参与者在大流行期间错过了治疗随访，主要是因为担心感染 COVID-19。与之前相比，68（24.6%）名患者在大流行期间癫痫发作次数增加。此外，56（20.3%）名参与者在大流行期间没有服用抗癫痫药物（ASMs），因为药物无法获得，他们也停止了去医院配药。在错过治疗随访的患者中，有 20%因癫痫发作而受伤。只有教育水平与大流行期间就诊有显著关联。因此，与无法读写的参与者相比，完成大学及以上学业的参与者（OR=2.58，95%CI（1.32-6.38））更有可能在大流行期间进行随访。
本研究表明，COVID-19 可能通过感染恐惧、旅行限制以及对药物的可及性和可负担性的间接影响，对治疗随访和药物依从性产生影响。这可能导致治疗效果不佳，如癫痫发作频率增加和与癫痫发作相关的身体损伤。
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