Sociodemographic, Rationale Drug Use of Antiepileptic Drugs among Pediatric Patients with Epilepsy: A Prospective Study at a Tertiary Care Hospital

Abstract

Background Drug utilization studies are important and considered as a potential tool for the evaluation of health care systems. The goal of drug utilization research studies should be to assess whether drug therapy is rational or not. Objective The main aim of this article is to analyze the different types of epilepsy and their drug utilization pattern in children with epilepsy at the Department of Pediatrics and evaluate the extent of older and newer antiepileptic drugs (AEDs), either as monotherapy or polytherapy in pediatric age groups. Materials and Methods To look into the sociodemographic profile of children with epilepsy, the type of epilepsy was diagnosed along with drug utilization pattern in children attending both outpatient and inpatient department of pediatrics. Demographic details were collected according to modified Kuppuswamy scale. Disease characteristics such as type of epilepsy, onset, duration, time since last attack, family history, comorbid conditions, monotherapy/polytherapy, dose, and duration of treatment were noted. Investigations such as electroencephalography, magnetic resonance imaging, and computed tomographic scan if any were recorded. Results In this pilot study, we have 100 patients, younger than 18 years, with confirmed cases of epilepsy, receiving AEDs either monotherapy or polytherapy. Male predominance was 56%, and 60% were from rural areas and 40% were from urban areas. As per the modified Kuppuswamy scale, we analyzed socioeconomic class of these 100 patients and found that 40% belong to lower-middle-class family. Nearly 51% were diagnosed with generalized tonic clonic seizures, 30% were with febrile seizures, while focal, partial, absence, and myoclonic seizures, and hot water epilepsy were less in percentage. Almost 83% received monotherapy, while only 17% received polytherapy. Among monotherapy, 51.80% received older AEDs and 48.20% received newer drugs. Conclusion Although epilepsy can be controlled and managed effectively with older AEDs, an experience in management with newer AEDs is required to offer an additional advantage to patients to have better safety profile.

A study of Rationale use of Sodium valproate and Levetiracetam as monotherapy in pediatric patients with Epilepsy at tertiary care hospital

“…In our study the total high incidence of epilepsy was observed with males (70.3%) which correlates with the results of previous studies conducted in India, Malaysia, and Oman (10,1) and study conducted in Bangalore by Dwajani et al, (11). We observed low incidence (29.6%) with females, reason could be due to poor reporting because of cultural factors.…”

“…When we considered age group between 1-18 years, we had majority (41.7%) patients from 1-5 years of age which was comparable to the research done by Hasan et al, in Malaysia (1) and study conducted by Dwajani et al, (11). We also observed that 23% of the patients were in 6-10 years of age.…”

A Comparative Study of Serum 25-Hydroxy Vitamin D Levels in Children with Seizures Receiving Monotherapy and Polytherapy

“…In a pilot study conducted on 100 children younger than 18 years confirmed as epilepsy, it was observed that 51% had generalized tonicclonic seizures, while 30% had febrile seizures and 40% participants had abnormal EEG findings. 13 In our study, the overall serum 25(OH)D levels was normal in 52% of children, 41.3% had insufficient levels, and 6.7% were deficient. Insufficient levels of vitamin D was present in 40% of children in monotherapy group and 52% in polytherapy group, while deficiency was present in 4 and 16% in monotherapy and polytherapy groups, respectively, which was statistically significant (p-value 0.047).…”

“…In a pilot study conducted on 100 children younger than 18 years confirmed as epilepsy, it was observed that 51% had generalized tonic-clonic seizures, while 30% had febrile seizures and 40% participants had abnormal EEG findings. 13…”

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“…Also, patient tolerability of adverse drug effects is integral to successful treatment 6 . Treatment with AEDs in children should be aimed and focused in such a way that controlling seizures with lesser side effects, possibly with monotherapy, allows the child to contribute actively to society with costeffective treatment 7 . However, the prescribing patterns of AEDs in children vary among countries because of differences in healthcare systems, cost of medicines, availability of drugs, and local and national epilepsy management guidelines 8 .…”