Impact of Pharmaceutical Interviews on the Medication Adherence of Epileptic Patients

Study Overview
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Brief Summary
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Many studies have reported a disparity in medication adherence among epileptic patients. In this population, Medication Possession Ratio (MPR) is an index of medication adherence. MPR is defined as the ratio of the number of days of treatment delivered to the number of days in the period of interest. No-adherents patients are defined by a MPR of less than 80% , in whom an increase in seizures and the rate of hospitalization can be observed. A pharmacist-led intervention and medication information to epileptic patients could improve patient medication adherence to antiepileptic drugs, and possibly decrease the frequency of seizures, hospitalizations and the health costs generated by these hospitalizations. This intervention could also improve patient knowledge about their medications. The aim of this study is to evaluate the effectiveness of a pharmacist-led intervention on medication adherence of epileptic patients with the MPR. Secondary objectives include the comparison of medication adherence with health insurance score, the evaluation of patients knowledges about their medications, community pharmacists' satisfaction about community hospital network, the comparison of the seizure free patient rate and the comparison of the rate of patient in whom seizure have decreased by 50%

Official Title
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Study of the Impact of Pharmaceutical Interventions on the Medication Adherence of Epileptic Patients and Their Medication Knowledge

Conditions
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Epilepsy

Intervention / Treatment
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* Other: Pharmacist intervention
* Other: Standard of care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Epileptic patients seeing a neurologist in the neurophysiology clinic with a regular follow-up by the Lille University Hospital reference center Adult over 18 years old Living at home Socially insured patient In the case of cognitive problems, the presence of a reliable caregiver managing the medications Exclusion Criteria: Inpatients Patient under curatorship, guardianship and/or institutionalized Dementia Patient who has participated in a therapeutic education program (TEP) about his epilepsy within the previous two years Administrative reasons: impossibility to receive informed information, impossibility to participate in the entire study, lack of coverage by the social security system, refusal to sign the consent form. Switching to home care by a registered nurse for treatment management

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pharmacist-led intervention<br> | Other: Pharmacist intervention<br>* In the intervention arm, the patient meets with the pharmacist. Pharmaceutical intervention (H1) about anti-epileptic drugs prescribed will be done: information on when to take the medication, what to do if you forget to take it or vomit, and an explanation of adverse events. The aim is to improve medication adherence and patient knowledge. A report will be sent to the community pharmacist. An assessment of medication adherence to antiepileptic drug by MPR at H1 3 months and 6 months (phone call to community pharmacist) will be done. The health insurance score will also be done. An assessment of patient knowledge by a self-made knowledge questionnaire (10 items) at H1 in pre- post interview -, 3 and 6 months (phone call to patient) will be done. An assessment of pharmacists' satisfaction about community hospital network by a satisfaction questionnaire will be done.<br>|
| Sham Comparator: Standard of care<br> | Other: Standard of care<br>* An assessment of medication adherence to antiepileptic drug by MPR at the inclusion then 3 months and 6 months later will be done by a phone call to the community pharmacist. An assessment of patient knowledge by a self-made knowledge questionnaire (10 items) at the inclusion then 3 and 6 months later will be done by a phone call to the patient. The health insurance score will be also done during this call.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication Possession Ratio (MPR) | Compare adherence to antiepileptic drugs between patients who received pharmacist led intervention and those who did not by Medication Possession Ratio (MPR) 3 months after inclusion | at 3 months after inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication Possession Ratio (MPR) | Compare adherence to antiepileptic drugs between patients who received pharmacist led intervention and those who did not by Medication Possession Ratio (MPR) 6 months after inclusion | at 6 months after inclusion | 
| Rate of MPR >80 percent | Compare the rate of adherent patients rate (MPR > 80 percent) between the two arms at 3 and 6 months | at 3 months and 6 months | 
| Pharmaceutical interview measured by responses to the knowledge Questionnaire (10-point score) | Evaluate the development (before vs after led pharmacist intervention) and maintenance of patient knowledge of patients received pharmacist intervention and compare them to the patient knowledge who received conventional management. | at 1 hour, 3 months and 6 months | 
| Satisfaction score on a Likert scale (score 1 to 5) | Evaluate the satisfaction of community pharmacist about community hospital network by a satisfaction questionnaire in the intervention group | at 3 months and 6 months | 
| Assessment of health insurance score (Score 0 to 6) | Compare drug adherence via the health insurance score between the 2 arms | at 3 months and 6 months | 
| Rate of patients with no seizures | Compare the rate of seizure free patients between the two arms | at 6 months | 
| Rate of patient in whom seizure have decreased by 50 percent | Compare the rate of patient in whom seizure have decreased by 50 percent between the two arms | at 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Treatment adherence, epilepsy, hospital pharmacy, clinical pharmacy, pharmacist intervention