Management, treatment outcome and cost of epilepsy in a tertiary health care facility in northern Nigeria

Abstract

This study aimed at reviewing the management and treatment outcome, and evaluating economic burden of antiepileptic drugs (AEDs) in Ahmadu Bello University Teaching Hospital, Kaduna (ABUTH). It was a retrospective study involving use of patients’ medical records. Data retrieved from the medical records included demographics, clinic attendance, laboratory investigations, type of seizure diagnosed, effect of seizure on social life, medication use and treatment outcome. Cost of medications for patients who adhered to their therapy consistently between November 2003 and October 2004 was calculated. Data analysis was by descriptive and inferential statistics using SPSS version 16. Epilepsy had negative effects on education and marital life of patients in this study. More than half (59.3%) of the patients were diagnosed as having generalized seizure disorder. Carbamazepine was the most commonly prescribed medication (91.2%). Patients who were less than 2 years of registration in the facility had the highest percentage of those who were not regular in their clinic attendance 2 (64.7%) and low remission rate (9.8%). Chi-square analysis showed that adherence to medications had a significant effect (p < 0.05) on attainment of remission among patients who had received care in the facility for more than a year. Seizure types had no significant effect (p>0.05) on attainment of oneyear remission. Average annual cost of AEDs was Nigerian Naira 30, 986.67 ($258.2). There was a strong correlation between clinic attendance and cost of AEDs (r = 0.454, p = 0.006) as cost of AEDs increased with increased in clinic attendance. Correlation analysis (p < 0.05, r = 0.358) also showed that cost of AEDs used by the patients reduced with increased in years since registration at this healthcare facility. Cost of AEDs did not depend on seizure type but increased with increase in clinic attendance and decreased with increase in years since registration in the healthcare facility.

KEY WORDS: Epilepsy; Cost; Management; AEDs; Remission