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.