3.2 Outcomes
Patients were categorized into six categories according to the frequency of seizures in the previous six months prior to enrolment: 1- no seizures 2- one to two seizures 3- three to five seizures 4- one or more seizures per month 5- one or more seizures per week and 6- one or more seizures per day. At follow-up, there was inability to classify patients in category three (three to five seizures) as the follow up period was two months and three to five seizures would classify the patient in category four (one or more seizure per month).
Efficacy of AEDs was measured by comparing the number of patients who became seizure free after eight weeks of enrolment. Both groups had a significant increase in the number of patients who became seizure free at follow up compared to baseline (Figure 3). The intervention group had 23 (63.9%) seizure free patients at follow up vs. 13 (31.7%) at baseline (P -value <0.001), and the control group had 17 (48.6%) at follow up vs. 11 (27.5%) at baseline (P -value <0.05). The difference at follow-up, however, was not statistically significant between groups (P - value > 0.05). Table 2 shows the results of study outcomes. Safety of AEDs, adherence to AEDs, satisfaction with information about AEDs and patients QoL were measured using the mean scores of PESQ, MMAS-8, SIMS and PedsQL epilepsy module, respectively (Figure 4). Mean PESQ was reduced in the intervention group from 21.08 ± 10.59 to 18.91 ± 9.44 (P -value <0.001), and increased in the control group from 21.42 ± 12.16 to 23.73 ± 13.24 (P -value <0.001); with no significant difference between the study groups at follow-up (P -value=0.08). At follow-up, the intervention group had a significant higher mean score of adherence of 7.6 ± 0.9 vs. 5.8 ± 1.4 in the control group (P- value <0.0001), besides that, patients categorized with high level of adherence were significantly increased in the intervention group (Figure 5). And higher satisfaction with information about AEDs in the intervention group of 12.58 ± 1.4 vs. 2.7 ± 2.68 in the control group at follow-up (P -value <0.0001), as well as higher QoL of 75.09 ± 14.87 vs. 64.6 ± 21.58 in the control group (P -value <0.05). Correlation test was also done to investigate the association between the study outcomes (Table 3), and between the study outcomes and patients’ demographic and clinical characteristics (Table 4).
4 DISCUSSION
This controlled interventional study aimed at assessing the impact of clinical pharmacist-led educational tool on pediatric patients with epilepsy in Jordan. Other studies should be done to have a more reliable, applicable and generalized findings. This study signifies the benefits from including the clinical pharmacist in the routine care of pediatric patients with chronic diseases including epilepsy. Improvements were also seen in the control group, and this underlines the importance of control group. Reasons for these improvements might be from the continued treatment at the specialized neurology clinics, and enthusiasm or motivation due to the baseline and follow up assessment done by the clinical pharmacist.