A community pharmacist intervention for people living with epilepsy

Abstract

Background

Epilepsy is a complex spectrum of seizure disorders. Antiseizure medications are the first-line treatment for most patients. Community pharmacists are among the most accessible health care providers with extensive knowledge of pharmacotherapy yet are seldom engaged in epilepsy care.

Objective

The objective of this project was to pilot a community pharmacist-led intervention for people living with epilepsy (PWE).

Methods

The Community Pharmacist Epilepsy Services Program was a 6-month disease state management intervention that included 4 components: patient-pharmacist consultation, care plan development, regular check-ins, and care coordination. A pilot was conducted in 4 independent community pharmacies (2 intervention and 2 comparator) in western Washington State. A prospective, 2-arm, pre-post study was planned to evaluate the impact of the intervention on patient-reported quality of life (QoL), health, and satisfaction outcomes. The approach shifted to a 1-arm pre-post design due to low patient recruitment. The primary QoL outcome was the patient-weighted Quality of Life in Epilepsy Inventory-10 (QOLIE-10-P). Staff at intervention and comparator pharmacies were surveyed to evaluate perceived barriers to patient recruitment.

Results

Ten patients, including 7 intervention and 3 usual care patients, enrolled in the study. Five intervention patients completed the pre- and postsurveys. The median pre-QOLIE-10-P score was 1.09 and the median postscore was 1.73, indicating a slight nonsignificant decrease in QoL. Eleven pharmacy staff completed the survey evaluating perceived patient recruitment barriers. Limited number of eligible PWE at each pharmacy was perceived as significant barriers.

Conclusion

While low patient enrollment limited the ability to observe trends and draw conclusions about the potential impact of the intervention, enrollment barriers and lessons learned highlight opportunities to refine the intervention with the goal of improving the outcomes and well-being of PWE.