Potentially inappropriate prescribing in elderly patients with epilepsy at two referral hospitals in Ethiopia

Tamrat Assefa Tadesse; Alemu Belayneh; Minychel Wale Aynalem; Yared Mamushet Yifru; Firehiwot Amare; Dessale Abate Beyene

doi:10.3389/fmed.2024.1403546

Potentially inappropriate prescribing in elderly patients with epilepsy at two referral hospitals in Ethiopia

Front Med (Lausanne). 2024 Aug 29:11:1403546. doi: 10.3389/fmed.2024.1403546. eCollection 2024.

Authors

Tamrat Assefa Tadesse¹, Alemu Belayneh¹, Minychel Wale Aynalem^{1

2}, Yared Mamushet Yifru³, Firehiwot Amare¹, Dessale Abate Beyene^{1

4}

Affiliations

¹ Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
² Department of Pharmacy, All Africa Leprosy Tuberculosis and Rehabilitation Training Centre Hospital, Addis Ababa, Ethiopia.
³ Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ Department of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia.

Abstract

Introduction: The prevalence of drug therapy problems in patients with epilepsy has been reported to be as high as 70-90%. Moreover, elderly patients with epilepsy are highly vulnerable to inappropriate therapies. This study aimed to evaluate potentially inappropriate prescriptions (PIP) in elderly patients with epilepsy at the adult neurology clinics of two referral hospitals in Addis Ababa, Ethiopia.

Methods: A cross-sectional study was conducted on 81 patients with epilepsy and the medication appropriateness index (MAI), the Beers, and Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to the Right Treatment (STOPP/START) criteria were used to assess PIP. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.

Results: Of the 81 study participants, 41(50.6%) were male, and the mean age was 67.33 ± 17.43 years. One-fourth of the study participants (25.9%) had polypharmacy and drug-drug interactions (DDIs) were documented in 64 (79%) patients. Based on the MAI, of the 263 medications that were prescribed for elderly epileptic patients, 110 (41.8%) had drug interactions, 44 (16.7%) had inappropriate indications, 31 (11.8%) were ineffective, and 12 (4.6%) were prescribed incorrect doses. Based on the STOPP and START criteria, PIP was reported in 31(38.3%) and 13(16.1%) patients, respectively.

Conclusion: Polypharmacy and DDIs are common in elderly epilepsy patients. The MAI, Beer's criteria, and STOPP/START criteria indicate a high prevalence of PIP in elderly patients with epilepsy.

Keywords: Ethiopia; elderly; epilepsy; polypharmacy; potentially inappropriate prescribing.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of the article. This research is supported by the Office of Community Engagement at Addis Ababa University Ethiopia.