Treatment outcome and associated factors among epileptic patients at ambulatory clinic of Mettu Karl Comprehensive Specialized Hospital: A cross-sectional study

Abstract

Objective: The study was aimed to assess the magnitude and associated factors of 2-year seizure-free status of epileptic patients at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Methods: A retrospective cross-sectional study was conducted at MKCSH from 12 February 2020 to 11 August 2020. Treatment outcome was measured in terms of seizure control status and seizure frequency. Accordingly, good treatment outcome was declared if the patients had a 2-year seizure-free status and poor if the patient had episodes of seizure in the last 2 years. The pharmaceutical care network Europe guideline was used to assess the presence of medication-related problems. Multivariable logistic regression was used to analyze the variables by using crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence interval (CI). Finally, the predictors of epilepsy treatment outcome were declared if a P-value was ⩽0.05. Results: Over the study period, more than half of the participants (172 (57.7%)) were males. The median age of participants was 29 and majorly distributed to 18–30 classes. More than one-fourth of the patients were suffering from absent seizure 85 (28.5%) and general tonic-clonic seizure 83 (27.9%). The most commonly prescribed medication was Phenobarbitone which accounts 34 (11.41%), whereas Valproic acid 8 (2.68%) was the least prescribed. Overall, less than half 131 (43.96%) of patients developed poor treatment outcomes. The predictors of treatment outcomes were having head the injury (AOR = 5.7; 95% CI: 3.18, 10.31), family history of epilepsy (AOR = 5.6; 95% CI: 3.07, 10.46) and the presence of drug therapy problems (AOR = 5.2; 95% CI: 2.79, 9.69). Conclusion: The magnitude of poor epilepsy treatment outcome was found to be high. The predictors of epilepsy treatment outcome were the history of head injury, family history of epilepsy and drug therapy problems. Therefore, to improve the treatment outcome of epileptic patients, health care providers should pay close attention to the identified factors. Besides this, the clinical pharmacy service should be implemented to minimize any medication-related problems