Pharmacoepidemiological aspects of the treatment of epilepsy in children

A. Scerri1, J. Mifsud1, D. Soler2, N. Calleja3. 1Dept of Clinical Pharmacology, University of Malta, Msida, MALTA, 2Dept of Paediatrics, Mater Dei Hospital, Msida, MALTA, 3Health Information Unit, Ministry of Health, Msida, MALTA.

Introduction The WHO’s 2013 report on ‘Priority Medicines for Europe and the World’ includes children among ‘special groups’ whose needs must be prioritised due to their unique health needs. This study investigated pharmacoepidemiological aspects of epilepsy in a population of Maltese children presenting to a paediatric clinic by establishing whether local practices followed principles of rational prescribing and whether Maltese children with epilepsy had access to the best available care.

Method The clinical records of 76 children with a diagnosis of epilepsy were reviewed retrospectively from the date of first presentation to hospital services to 31st December 2013. Schedule V records were consulted to determine how many children in Malta were receiving free antiepileptic drug therapy. Data was input into a spreadsheet and analysed.

Results In this study, valproate was the most commonly prescribed AED (40.8%) in this specific group of children. Lamotrigine was the most commonly prescribed newer AED (19.7%). Older AEDs were more commonly used overall. The most commonly prescribed AED combination was of valproate with lamotrigine. 48.7% of children were receiving AEDs as monotherapy. 35.5% were in remission and off AED therapy on the 31st December 2013. The lowest prevalence of children with epilepsy in this group was in Gozo while the highest was in the South Harbour district of the Maltese Islands.

Conclusion This data indicates that children with epilepsy in Malta are treated using similar treatment protocols as in many other countries. Data obtained from this study can be used to access to the best available care for this group of children. Clinical practice guidelines applicable to primary and secondary care scenarios can also be designed using this data.

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