Role of clinical pharmacists in epilepsy management at a general hospital in Vietnam: a before-and-after study

Background: Clinical pharmacists have an important role in inter-professional healthcare collaboration for epilepsy management. However, the pharmacy practices of managing epilepsy are still limited in Vietnam, deterring phar‑ macists from routine adjustments of antiepileptic drugs, which could decrease the patients’ quality of life. This study aimed to assess the efectiveness of pharmacist interventions in epilepsy treatment at a Vietnamese general hospital. Methods: A before-and-after study was conducted from January 2016 to December 2018. All patients with a diagno‑ sis of epilepsy and being treated at the investigated hospital were recruited and screened for eligibility and exclusion criteria. The primary outcome was the proportion of patients in good control of their epilepsy (with two seizures or less in a year). The secondary outcome was the number of patients maintaining optimized concentrations within the therapeutic range of carbamazepine (4–12 mg/L), phenytoin (10–20 mg/L), or valproic acid (50–100 mg/L). Collected data were analyzed using two proportions Z-test or Chi-square test. Results: A total of 141 participants were enrolled in the study. While most patients were given lower prescribed daily doses than the recommendations from the World Health Organization, over 56% of the participants still experienced adverse drug efects. More than half of the patients received at least one pharmacists’ intervention, which increased by 25.0% the efectiveness of the therapy (p<0.001) and by 14.6% the number of patients with optimized drug con‑ centrations (p=0.018). Conclusion: Epilepsy management requires a multiple-stepped and comprehensive approach, with a focus on the health and safety of the patients. As part of the healthcare team, pharmacists need to engage at every stage to moni‑ tor the patient’s response and determine the most efective treatment with the fewest adverse drug reactions
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Background: Clinical pharmacists have an important role in inter-professional healthcare collaboration for epilepsy management. However, the pharmacy practices of managing epilepsy are still limited in Vietnam, deterring phar‑ macists from routine adjustments of antiepileptic drugs, which could decrease the patients’ quality of life. This study aimed to assess the efectiveness of pharmacist interventions in epilepsy treatment at a Vietnamese general hospital. Methods: A before-and-after study was conducted from January 2016 to December 2018. All patients with a diagno‑ sis of epilepsy and being treated at the investigated hospital were recruited and screened for eligibility and exclusion criteria. The primary outcome was the proportion of patients in good control of their epilepsy (with two seizures or less in a year). The secondary outcome was the number of patients maintaining optimized concentrations within the therapeutic range of carbamazepine (4–12 mg/L), phenytoin (10–20 mg/L), or valproic acid (50–100 mg/L). Collected data were analyzed using two proportions Z-test or Chi-square test. Results: A total of 141 participants were enrolled in the study. While most patients were given lower prescribed daily doses than the recommendations from the World Health Organization, over 56% of the participants still experienced adverse drug efects. More than half of the patients received at least one pharmacists’ intervention, which increased by 25.0% the efectiveness of the therapy (p<0.001) and by 14.6% the number of patients with optimized drug con‑ centrations (p=0.018). Conclusion: Epilepsy management requires a multiple-stepped and comprehensive approach, with a focus on the health and safety of the patients. As part of the healthcare team, pharmacists need to engage at every stage to moni‑ tor the patient’s response and determine the most efective treatment with the fewest adverse drug reactions
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