Pattern of utilization of antiepileptic drugs in the first 12 months of epilepsy treatment in children

Abstract

Background: Drug utilization studies are important methods of assessing how drugs are used in the society. Without the knowledge of how drugs are being prescribed and used, it is difficult to initiate discussion on rationale drug use and to suggest measures to change prescribing habits for better management of patients. This study therefore aimed to evaluate the pattern of utilization of antiepileptic drugs (AEDs) in the first 12 months of epilepsy treatment in children in Jos, Nigeria.
Methods: A case record form was used to document all relevant information of children with epilepsy that were commenced on AED from January 2011 to December 2015. Information collected in the first 12 months of commencement of AED was used to evaluate the pattern of utilization of AEDs among the study subjects. Information obtained was analyzed with statistical package for social sciences software version 20.
Results: Three hundred and eighty one subjects with a median age of 5.4 years were studied. The most frequently prescribed drug at commencement of epilepsy treatment was Carbamazepine (CBZ) (75.9%) followed by Sodium Valproate (VPA) (17.1%) while the most frequent AED combination was CBZ+VPA. Despite the fact that all the patients were commenced on monotherapy, the rate of polytherapy at 12 months was 35.2%. Deviation from standard treatment guidelines was observed in 127 (33.3%) of the subjects with the most common deviation being the use of CBZ for generalized tonic-clonic seizures.
Conclusion: Significant deviations were observed in the utilization of AEDs in children with epilepsy. Using standard guidelines in the treatment of childhood epilepsy will reduce the rate of uncontrolled seizures and improve their long term outcome.

Keywords: Epilepsy, Children, Antiepileptic drugs, Pattern, Utilization