Follow Up Evaluation of Pediatric Epileptic Patients: A Prospective Clinical Study

Abstract

Objective: To investigate the follow up evaluation of pediatric epileptic patients and to determine the problems in epilepsy treatment that need improvement. Methods: This prospective study was conducted in the Neurology Department at Children Hospital Lahore. A Pharmaceutical Care Plan was developed which included Subjective information, Objective information, Assessment and Plan of the condition of patient followed by definitive plan for assessment of adverse drug reactions, drug-drug interactions and pharmacoecnomics. 100 patients having age ≤ 15 years with uncomplicated epileptic seizures were followed for seven months. Data was analyzed by routine statistical methods. Results: Commonly encountered cases were tonic clonic 39%, myoclonic 12%, petitmal 11% and complex partial seizures 9%. Results show that most commonly prescribed drug was Valproic acid used in 67% cases. Patients stable on monotherapy were 57 %. Patients with appropriate dose were 89%. Generic prescribing was done in 10% cases. Patient who received antibiotics and multivitamins were 19% and 21% respectively. Adverse drug reactions were observed in 13% cases. The patients with poor education, medium education and good education were 7.9, 63 and 28.6 percent respectively. Compliance was satisfactory in 72% patients. Patients with well-controlled fits were 25%. Mean cost of treatment for one month at start and end study was Rs. 576 ± Rs. 345 and Rs. 716 ± Rs. 422 respectively. Various wrong views about epilepsy are common in our society like patients who consider it due to evil spirits were 36%, and 24% of these patients in the start of disease strictly take a treatment from faith holders for the cure of disease. Conclusion: There is a great need for the education of our society about epilepsy and its proper treatment. The discrepancies observed in the treatment of epilepsy were due to absence of pharmacist in our health care system. If pharmacist checks all the prescriptions, maintains pharmaceutical care plan of all the patients under SOAP format and implements guidelines of Standard Pharmaceutical Care Plan, the quality of life of epileptic patients can be improved. Likewise, cost of the treatment can be reduced.