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尼日利亚西南部癫痫患者的处方模式与治疗差距

Prescription patterns and therapeutic gaps among persons with epilepsy in Southwestern Nigeria.

作者信息

Ogunjimi Luqman, Osalusi Bamidele, Fagbemi Ayotomiwa, Oyenuga Ibironke, Ojini Fedora, Collins Samuel, Elegbede Oluwatosin, Oladele Olayinka, Fehintola Fatai

机构信息

Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Ago Iwoye, Nigeria.

Department of Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Ago Iwoye, Nigeria.

出版信息

Front Pharmacol. 2024 Aug 7;15:1430716. doi: 10.3389/fphar.2024.1430716. eCollection 2024.

Abstract

Pharmacotherapy with antiseizure medications (ASMs) has been a cornerstone for achieving long-term remissions in persons with epilepsy (PWEs). This study aims to determine the prescription patterns and treatment gaps (TGs) among PWEs. Accordingly, a descriptive cross-sectional study was conducted with 940 PWEs aged ≥18 years having clinically confirmed diagnosis of epilepsy based on the International League Against Epilepsy (ILAE) criteria. At a scheduled interview with each participant, a previously established questionnaire was used to obtain clinical information relating to epilepsy in terms of the age of onset, etiology, duration of epilepsy, frequency, types, and number of ASMs used. There were fewer male participants [445 (47.4%) vs. 495 (53.6%)] than females, with a higher mean age of onset [(35.19 ± 21.10 vs. 31.58 ± 20.82 years; p = 0.009]. The medication characteristics showed that 336 (35.7%) of the 940 PWEs recruited were not on any ASMs, whereas the remaining 604 (64.3%) patients were on ASMs, with 504 (83.4%) on monotherapy vs. 100 (16.6%) on polytherapy. The PWEs on ASM monotherapy had a higher mean age [40.92 ± 19.40 vs. 33.61 ± 16.51 years; < 0.001] and higher mean age of onset [34.47 ± 21.80 vs. 25.39 ± 19.78 years; < 0.001] than those on polytherapy. Furthermore, there were more persons on ASM monotherapy among the participants with seizure duration < 2 years [251 (87.5%) vs. 36 (12.5%)] and seizure duration > 2 years [253 (79.8%) vs 64 (20.2%)]. The majority of the participants receiving ASMs were on monotherapy, with carbamazepine being the most frequently prescribed medication. Furthermore, about a third of the participants had TGs; therefore, healthcare providers should focus on alleviating the TGs among PWEs.

摘要

使用抗癫痫药物(ASMs)进行药物治疗一直是实现癫痫患者(PWEs)长期缓解的基石。本研究旨在确定癫痫患者的处方模式和治疗差距(TGs)。因此,对940名年龄≥18岁、根据国际抗癫痫联盟(ILAE)标准临床确诊为癫痫的患者进行了描述性横断面研究。在与每位参与者的定期访谈中,使用预先制定的问卷获取与癫痫相关的临床信息,包括发病年龄、病因、癫痫持续时间、发作频率、类型以及使用的抗癫痫药物数量。男性参与者[445名(47.4%)对495名(53.6%)]少于女性,平均发病年龄更高[(35.19±21.10岁对31.58±20.82岁;p = 0.009]。药物治疗特征显示,在招募的940名癫痫患者中,336名(35.7%)未使用任何抗癫痫药物,而其余604名(64.3%)患者使用了抗癫痫药物,其中504名(83.4%)接受单药治疗,100名(16.6%)接受联合治疗。接受抗癫痫药物单药治疗的癫痫患者平均年龄更高[40.92±19.40岁对33.61±16.51岁;<0.001],平均发病年龄也更高[34.47±21.80岁对25.39±19.78岁;<0.001],高于接受联合治疗的患者。此外,在发作持续时间<2年的参与者[251名(87.5%)对36名(12.5%)]和发作持续时间>2年的参与者[253名(79.8%)对64名(20.2%)]中,接受抗癫痫药物单药治疗的人数更多。接受抗癫痫药物治疗的大多数参与者采用单药治疗,卡马西平是最常处方的药物。此外,约三分之一的参与者存在治疗差距;因此,医疗服务提供者应关注减轻癫痫患者的治疗差距。

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本文引用的文献

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Epilepsy in adults.成人癫痫。
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