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Chandok A, Mahmoud SH. A Survey of Canadian Pharmacists’ Knowledge and Comfort in the Management of Epilepsy and Antiepileptic Drugs. J Pharm Technol 2022; 38:95-105. [PMID: 35571344 PMCID: PMC9096845 DOI: 10.1177/87551225211069489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: As antiepileptic drugs (AED) remain the mainstay of epilepsy management, pharmacists have the potential to play an integral role in the management. Objective: The goal of our study was to characterize Canadian pharmacists’ knowledge and comfort in managing epilepsy and AED and identify areas of need for the development of support tools. Methods: An electronic survey was designed and distributed to Canadian pharmacists through professional organizations. The survey consisted of 4 sections, including demographics, knowledge, comfort, and needs assessment around epilepsy management. Results: A total of 605 complete responses were included. Nearly two-thirds of the participants were females (61.6%) and most reported more than 10 years of practice experience (61.6%). For comfort, a majority of the participants responded agree or strongly agree to the statement inquiring about the comfort in checking prescriptions, answering questions about drug interactions, and counseling on AED. Conversely, more than 50% of the participants selected disagree or strongly disagree when asked about their comfort regarding interpreting therapeutic drug monitoring and assisting patients withdraw from AED. For the knowledge section, the overall average score was 57.6% ± 19.1%. Hospital practice, recent graduation, and neurology experience were independent predictors of high scores. Many participants indicated a need for tools addressing newer AED and monitoring of therapy. Conclusion: Although Canadian pharmacists displayed knowledge and comfort in certain aspects of epilepsy management, some clear knowledge and comfort gaps are prevalent. These findings indicate a need for the development of epilepsy educational support tools.
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Affiliation(s)
- Akshita Chandok
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Sherif Hanafy Mahmoud
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
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Sengxeu N, Aon C, Dufat H, Boumediene F, Chan S, Ros S, Preux PM, Ratsimbazafy V, Jost J. Availability, affordability, and quality of essential anti-seizure medication in Cambodia. Epilepsia Open 2021; 6:548-558. [PMID: 34101380 PMCID: PMC8408618 DOI: 10.1002/epi4.12514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/16/2021] [Accepted: 05/30/2021] [Indexed: 01/22/2023] Open
Abstract
Objective Epilepsy is a major neurological disorder that requires long‐term medical treatment. Once epilepsy is diagnosed, people with epilepsy face many difficulties in accessing treatment (treatment gap). Our objective was to assess the situation regarding the availability, price, affordability, and quality of anti‐seizure medication (ASM), which are major determinants of access to treatment. Method A cross‐sectional study was performed in provincial/district hospitals and private pharmacies in urban and rural areas in Cambodia. Data on ASM availability and price were obtained through drug suppliers. Affordability was estimated as the number of day wages the lowest‐paid government employee must work to purchase a monthly treatment. Samples of ASM were collected, and the quality of ASM was assessed through Medicine Quality Assessment Reporting Guidelines. Results Out of 138 outlets visited, only 72 outlets (52.2% [95% CI 43.5‐60.7]) had at least one ASM available. Phenobarbital 100 mg was the most available (35.5%), followed by carbamazepine 200 mg (21.7%), phenobarbital 50 mg (11.6%), sodium valproate 500 mg (9.4%), and phenytoin 100 mg (9.4%). In provincial/district hospitals, ASM was provided free of charge. In private pharmacies, affordability for phenobarbital 50 mg and 100 mg was the best, with 0.6 and 0.5 days, respectively, compared to phenytoin 100 mg (1.8 days), and other ASM. No counterfeit ASM was found in this study. Phenytoin sample presented the worst quality (33.0%) compared to carbamazepine (27.8%), and other ASM. Significance A lack of access to affordable and effective ASM due to low availability and poor quality of ASM was identified. Our research highlights the need for future policy efforts to ensure the quality of ASM and improve their availability. This can be achieved by involving the calculation of their annual needs for these drugs and increasing the national production of ASM.
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Affiliation(s)
- Noudy Sengxeu
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Faculty of Pharmacy, University of Health Sciences, Vientiane, Lao PDR
| | - Chanraksmey Aon
- Cambodian Society of Neurology, Calmette Hospital, Phnom Penh, Cambodia
| | - Hanh Dufat
- Natural Products, Analysis and Synthesis, CiTCoM (Cibles Thérapeutiques et Conception de Médicaments)-UMR 8038 CNRS/Université de Paris, Faculty of Health-Pharmacie, Université de Paris, Paris, France
| | - Farid Boumediene
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Samleng Chan
- Cambodian Society of Neurology, Calmette Hospital, Phnom Penh, Cambodia
| | - Sina Ros
- Cambodian Society of Neurology, Calmette Hospital, Phnom Penh, Cambodia
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Voa Ratsimbazafy
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Pharmacy, CHU Limoges, Limoges, France
| | - Jeremy Jost
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Pharmacy, CHU Limoges, Limoges, France
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