Evaluation of differences in health-related quality of life in patients receiving conventional versus newer anti-epileptic drugs

Kavisha S. Goswami; Devang A. Rana; Shalin Shah; Supriya D. Malhotra

doi:10.18203/2319-2003.ijbcp20200188

Authors

Kavisha S. Goswami Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
Devang A. Rana Department of Pharmacology,Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
Shalin Shah Department of Neurology, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
Supriya D. Malhotra Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20200188

Keywords:

Drug use pattern, Epilepsy, Quality of life, HR-QOL, Prescription pattern

Abstract

Background: Epilepsy is associated with stigma and bad health-related quality of life (HR-QOL) due to this, and side effects of the drug therapy. Newer anti-epileptics are claimed to be better than the conventional. We evaluated this based on comparison of HR-QOL in patients taking the respective therapy.

Methods: An observational, cross-sectional, single point study involved 127 consenting patients from Neurology OPD at V.S. General Hospital. Quality of life in epilepsy-10 (QOLIE-10) questionnaire was used to measure HR-QOL in patients. SPSS software and Graphpad prism were used to analyze the variables.

Results: Patients of 20-30 age group were commonly affected (37.80%) with a male predominance (56.69%). 41.73% were unemployed. The difference in HR-QOL between patients and controls in all three domains (epilepsy effects, mental effects, role function domains) of QOLIE-10 was significant (p=0.0002), indicating better HR-QOL in controls. The worst HR-QOL scores were found in Epilepsy effects domain. Metabolic adverse effects (38.58%) were the common ADRs. Sodium valproate was the most effective in controlling seizures (last seizure episode: 15 months). HR-QOL correlation between patients receiving monotherapy and polytherapy was significant (p=0.026) with monotherapy rendering a better HR-QOL. Comparison of HR-QOL between patients taking the conventional and the newer drugs was not significant (p=0.1768).

Conclusions: Our study nullifies the claims that newer drugs are better than the conventional since no such benefit was seen in HR-QOL as well as ADRs. Our findings ruled out the belief that cases of epilepsy are better controlled with polytherapy.

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References

Senthil A, Gopalkrishna G, Parthasarathy S. Epilepsy in India I: Epidemiology and public health. Annal Indian Acad Neurol. 2015;18(3):263-77.

Santulli L, Coppola A, Balestrini S, Striano S. The challenges of treating epilepsy with 25 antiepileptic drugs. Pharmacol Res. 2016;107:211–9.

Chung S, Ceja H, Gawlowicz J, McShea C, Schiemann J, Levetiracetam LS. Extended release for the treatment of patients with partial-onset seizures: a long-term, open-label follow-up study. Epilepsy Res. 2016;120:7–12.

Panebianco M, Zavanone C, Dupont S, Restivo D, Pavone A. Vagus nerve stimulation therapy in partial epilepsy: a review. Acta Neurol Belg. 2016;116(3)1–8.

French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, et al. Therapeutics and technology assessment subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2004;62(8):1261–73.

Jacoby A. Epilepsy and the quality of everyday life: findings from a study of people with well-controlled epilepsy. Soc Sci Med. 1992;34:657-66.

Baker GA, Jacoby A, Buck D, Stalgis C, Monnet D. Quality of life of people with epilepsy: a European study. Epilepsia. 1997;38:353-62.

Thomas SV, Koshy S, Nair CR, Sarma SP. Frequent seizures and polytherapy can impair quality of life in persons with epilepsy. Neurol India. 2005;53:46-50.

Cramer JA, Perrine K, Devinsky O, Meader K. A brief questionnaire to screen for quality of life in epilepsy: the HR-QOLIE-10. Epilepsia. 1996;37:577-82.

Amudhan S, Satishchandra P, Gururaj G. Epilepsy in India I: Epidemiology And Public Health. Annal Indian Acad Neurol. 2015;18(3):266-77.

Mathur S, Sen S, Ramesh L, Kumar S. Utilization pattern of antiepileptic drugs and their adverse effects, in a teaching hospital. Asian J Pharmaceut Clin Res. 2010;3(1):55-9.

Hasiso TY, Desse TA. Adherence to Treatment and Factors Affecting Adherence of Epileptic Patients at Yirgalem General Hospital, Southern Ethiopia: A Prospective Cross-Sectional Study. Plos One. 2016;11(9):e0163040.

Poduri A, Lowenstein D. Epilepsy Genetics—Past, Present, and Future. Curr Opin Genet Dev. 2011;21(3):325–32.

Malerba A, Ciampa C, De Fazio S, Fattore C, Frassine B, La Neve A, et al. Patterns of prescription of antiepileptic drugs in patients with refractory epilepsy at tertiary referral centres in Italy. Epilepsy Res. 2010;91(2–3):273-82.

De Gaspari C, Guerreiro C. Modification in body weight associated with antiepileptic drugs. Arq Neuropsiquiatr. 2010;68(2):277-81.

George J, Kulkarni C, Sarma GRK. Antiepileptic Drugs and Quality of Life in Patients with Epilepsy: A Tertiary Care Hospital-Based Study. Value Health Reg Issues. 2015;6:1-6.