Prescription Patterns and Risk Factors for Seizure Control Among Adult Epileptic Patients at the Kenyatta National Hospital

Abstract

Background Epilepsy, a neurological disorder characterized by recurrent seizures, presents complex and multifaceted challenges to patients in Low and Middle-Income Countries. Objective To describe the prescribing of antiepileptic drugs, and determine risk factors for uncontrolled seizures among adult epileptic patients receiving treatment at the neurology clinic of the Kenyatta National Hospital. Methodology A cross-sectional study design was adopted for this study where 185 adult epileptic patients participated between June and September 2023. Controlled seizures were defined as the absence of seizures in the preceding one-year. Uncontrolled seizures were described as experiencing at least one seizure episode in the past year. Logistic regression was carried out to identify the risk factors associated with uncontrolled seizures where a p-value of < 0.05 was used to define a significant association. Results Oral carbamazepine was the most prescribed AED at 107(57.8%) of all prescriptions followed by sodium valproate and levetiracetam. Only 71(38.4%) participants were adherent to their antiepileptic drugs. A total of 57(30.8%) participants were seizure-free in the past year and were considered to have controlled seizures. Multivariate logistic regression identified non-adherence to antiepileptic drugs, treatment with phenobarbitone, sodium valproate, levetiracetam and head trauma as the primary cause of the first seizure to be significantly associated with uncontrolled seizures. Conclusion Carbamazepine was the most prescribed antiepileptic drug. Approximately half of the study participants were on polytherapy. One-third of participants were seizure-free in the preceding year. Interventions to improve adherence to antiepileptic drugs can considerably improve seizure control among adult epileptic patients