Background and Purpose: The objective of this study was to evaluate the prescribing trends and the cost analysis (Fiscal impact analysis) of antiepileptic drugs (AEDs) at a tertiary care hospital.
Material and Methods: A retrospective data of 70 patients selected randomly, who were prescribed AEDs during July 2014 to Jan 2015 was gathered. It includes the AEDs prescribed to the patients in outpatient and inpatient. Patients were assessed for the prescribing indication, doses depending upon co-morbidities, duration of therapy, drug interactions, cost analysis, blood level monitoring and toxicity symptoms. Guidelines stated in the ACCP updates in therapeutics 2015 and NICE guidelines were followed as reference to conduct this study. Prescription evaluation for appropriateness of AED use was carried out by the staff clinical pharmacist and reviewed by senior clinical pharmacist.
Results and Discussion: Out of 70 patients 33(47.1%) were prescribed multiple AEDs; with 19(57.5%) patients prescribed unnecessarily. In these 19 patients, 6(18.1%) received triple regimen and 13(39.39) received double regimen. While out of 70 patients, 29(41.4%) were prescribed with irrational AED therapy on the basis of inappropriate dose, duration and indication and monitoring parameters.
Total cost spent on irrational prescribing was PKR 393,162 approximately.
Inappropriate use of AEDs leads to unnecessary drug exposure, risk of toxicities and wastage of cost.
Keywords: Antiepileptic drugs (AEDs), Central nervous system (CNS), Gamma amino butyric acid (GABA), Gabapentine (GBP), Carbamazepine (CBZ), Therapeutic drug monitoring (TDM)
Abbreviations: ACCP: American College of Clinical Pharmacy: NICE: National Institute for Health and Care Excellence
