Medication education for patients with epilepsy in Taiwan

Liu, Lillian; Yiu, Chun Hing; Yen, Der‐Jen; Chou, Mei-Huei; Lin, Ming-Fang

doi:10.1016/s1059-1311(03)00006-2

Cited by 34 publications

(20 citation statements)

References 11 publications

(12 reference statements)

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“…Most (67%) of the patients in our study was successfully maintained on monotherapy. Various first generation AEDs like PHB, PHT, CBZ, VPA and clonazepum are widely used as monotherapy in most of the Asian countries [25]–[30]. A series of trials by Reynolds and Shorvon [31]–[33] also showed similar effectiveness with monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Antiepileptic drug utilization in Bangladesh: experience from Dhaka Medical College Hospital

et al. 2013

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BackgroundEpilepsy is a common health problem which carries a huge medical social psychological and economic impact for a developing country. The aim of this hospital-based study was to get an insight into the effectiveness and tolerability of low cost antiepileptic drugs (AEDs) in Bangladeshi people with epilepsy.MethodsThis retrospective chart review was done from hospital records in weekly Epilepsy outdoor clinic of Department of Neurology, Dhaka Medical College Hospital (DMCH) from October 1998 to February 2013. A total of 854 epilepsy patients met the eligibility criteria (had a complete record of two years of follow up data) from hospital database. A checklist was used to take demographics (age and gender), epilepsy treatment and adverse event related data. At least two years of follow up data were considered for analysis.ResultsOut of 854 patients selected, majority of the patients attending outdoor clinic were >11-30 years age group (55.2%) with a mean age of 20.3 ± 9 years and with a male (53%) predominance. Focal epilepsy were more common (53%), among whom secondary generalized epilepsy was the most frequent diagnosis (67%) followed by complex partial seizure (21%). Among those with Idiopathic Generalized Epilepsy (46%), generalized tonic clonic seizure was encountered in 74% and absence seizure was observed in 13%. The number of patients on monotherapy and dual AED therapy were 67% and 24% respectively and polytherapy (i.e. >3 AEDs) was used only in 9%. CBZ (67%) was the most frequently prescribed AED, followed by VPA (43%), PHB (17%), and PHT (8%). CBZ was prescribed in 37% patients as monotherapy followed by VPA in 21% and PHB in 8% patients. Newer generation drugs eg lemotrigine and topiramate were used only as add on therapy in combination with CBZ and VPA in only 2% patients. The treatment retention rates over the follow up period for the AEDs in monotherapy varied between 86 and 91% and were highest for CBZ, followed by VPA. Most of the combination regimens had a treatment retention rate of 100%. The effectiveness of AED in terms of reduction of seizure frequency was highest for PHT (100%) and PHB (98%) followed by CBZ (96%) and VPA (95%). PHB and PHT were the cheapest of all AEDs (42 I$ and 56 I$/ year respectively). The costs of VPA and CBZ were two times and LTG and TOP were six to eight times higher. Adverse drug reaction (ADR) were observed among 140 (24.5%) of those with monotherapy. PHT (64%) was the most common drug to cause ADR, CBZ was at the bottom of the list to cause adverse effect (11.6%). VPA and PHB caused weight gain commonly. Adjustment of drug dose or withdrawal due to ADRs was necessary in 39% with PHT and 26% with PHB.ConclusionThough PHT and PHB are cheapest and efficacious among all, CBZ and VPA are less costly, effective and well tolerated drug for seizure control in context of Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Antiepileptic drug utilization in Bangladesh: experience from Dhaka Medical College Hospital

et al. 2013

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“…Liu et al [36] report that a reduction of the adverse side effects of AEDs can be achieved through patient education about their medication which will in turn reduce misinterpretation of how to take the medication and non-compliance.…”

Section: Adverse Reactions To Aedsmentioning

confidence: 99%

General practitioners' perceptions on management of epilepsy in primary care settings in Cape Town, South Africa: An exploratory pilot study

Keikelame

Hills

Naidu

et al. 2012

Epilepsy & Behavior

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“…The amount of confidence patients have in their medication is one of the factors influencing its regular intake [15] ; therefore, if confronted with ineffective medication of poor quality, confidence in the treatment may be lost.…”

Section: Availability and Costs Of Antiepilepticmentioning

confidence: 99%

Availability and Costs of Antiepileptic Drugs and Quality of Phenobarbital in Vientiane Municipality, Lao PDR

Odermatt

Simmala

et al. 2007

Neuroepidemiology

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Purpose: In developing countries, availability and quality of drugs are critical factors for effective management and control of epilepsy. This study investigated the availability and costs of antiepileptic drugs (AEDs), and the quality of phenobarbital in Vientiane Municipality, Lao PDR. Methods: In March 2004, we enrolled all pharmacies (categories I and II) of four central districts of Vientiane eligible to sell AEDs. Two hundred and eight pharmacies of category III (75.1% of all registered pharmacies) were excluded as the sale of AEDs was not authorized. All pharmacists were interviewed with a standard questionnaire. Whenever phenobarbital was available, a sample was purchased and assayed by liquid chromatography. Phenobarbital was defined as being of correct quality if the active substance average content corresponded to ±15% of the indicated amount. Results: 66 pharmacies were enrolled (13 and 45 of categories I and II, respectively, and 8 hospital pharmacies). Six generics of AEDs were found (phenobarbital, phenytoin, valproic acid, clonazepam, carbamazepine, diazepam) and all pharmacies sold at least 1 AED. The 2 most widely available drugs were diazepam (5 mg) and phenobarbital (100 mg), present in 87.9 and 53.0% of the pharmacies, respectively. All 34 phenobarbital samples examined showed a correct concentration of the active compound. However, the concentration of phenobarbital 100 mg tablets produced in Lao PDR (mean concentration 94.7 mg) was significantly lower (p = 0.005) than the imported equivalent (mean concentration 99.7 mg). The direct drug costs of a yearly treatment with phenobarbital were estimated to be at least 25.2 USD. Conclusions:A variety of AEDs are present. Their availability, particularly of phenobarbital, is restricted to higher-category pharmacies and within those it is rather limited. To meet the costs of AEDs in this setting is a major challenge for people with epilepsy. However, the quality of the available phenobarbital was rather satisfactory.

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Medication education for patients with epilepsy in Taiwan

Cited by 34 publications

References 11 publications

Antiepileptic drug utilization in Bangladesh: experience from Dhaka Medical College Hospital

Antiepileptic drug utilization in Bangladesh: experience from Dhaka Medical College Hospital

General practitioners' perceptions on management of epilepsy in primary care settings in Cape Town, South Africa: An exploratory pilot study

Availability and Costs of Antiepileptic Drugs and Quality of Phenobarbital in Vientiane Municipality, Lao PDR

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