An evaluation of pharmacist knowledge on treatment with antiepileptic drugs.

PURPOSE: As pharmacists play an important role in managing antiepileptic drug (AED) therapy, they should be aware of different aspects of the treatment. Our aim was to evaluate pharmacists' knowledge of the pharmacological treatment of epilepsy, and their recommendations under hypothetical situations, through a written questionnaire. METHODS: The questionnaire included 22 questions divided into three sections: demographic data (eight questions), knowledge of specific aspects of AED therapy (true/false; four questions), and actions taken in theoretical situations involving AED therapy (multiple choice; ten questions). The questionnaire was distributed to pharmacists practicing in Israel and working in pharmacies and/or participating in professional meetings and continued education programs. RESULTS: One hundred and twenty one pharmacists completed the questionnaire (response rate 19%). The mean overall score was 48 ± 15% correct answers. Most pharmacists were aware of the need to continue AED treatment during pregnancy, the risk of generic switches, and the need to call the physician for loss of seizure control (92%, 89% and 81% of responders, respectively). Twelve percent identified correctly all three situations in which the clinicians should be contacted urgently, and 27% did not identify any of them. The total score was related to the academic degree (PharmD vs. other) and to the duration since training completion. CONCLUSION: Pharmacists were knowledgeable regarding some aspects of care of people with epilepsy. However, our study, as in previous studies among health care professionals, identified some gaps in knowledge. These findings indicate the need for better education of pharmacists regarding epilepsy and its treatment.

Concomitant therapy in people with epilepsy: potential drug-drug interactions and patient awareness.

People with epilepsy (PWE) may use prescription and over-the-counter (OTC) drugs for the treatment of concomitant diseases. Combinations of these drugs, as well as dietary supplements, with antiepileptic drugs (AEDs) may lead to reduced control of seizures and of coexisting medical conditions and increased risk of adverse drug reactions (ADRs). The aims of this study were to obtain comprehensive lists of medications, dietary supplements, botanicals, and specific food components used by adult PWE and to evaluate the potential for interactions involving AEDs and patients' awareness of such potential interactions. We conducted a prospective, questionnaire-based study of PWE attending the Hadassah-Hebrew University Epilepsy Clinic over a period of 7months. The questionnaire interview included the listing of medications, medicinal herbs, dietary supplements, and specific food components consumed and the knowledge of potential drug-drug interactions (DDIs), and it was conducted by a pharmacist. Drug-drug interactions were analyzed via the Micromedex online database. Out of 179 patients who attended the clinic over the study period, we interviewed 73 PWE, of which 71 were included in our final analysis. The mean number of AEDs consumed per subject was 1.7 (SD: 0.8, range: 1-4). Forty (56%) subjects were also treated with other prescription and/or OTC medications, and thirty-four (48%) took dietary supplements. Drug families most prone to DDIs involving AEDs included antipsychotic agents, selective serotonin reuptake inhibitors, and statins. Two-thirds of study participants (67%) knew that DDIs may lead to ADRs, but only half (56%) were aware of the potential for reduced seizure control. Only 44% always reported treatment with AEDs to medical professionals. This study provides for the first time a comprehensive picture of prescription and OTC drugs and food supplements used by PWE. Despite a considerable potential for DDIs involving AEDs, patient awareness is limited, highlighting the importance of patient and caregiver education.