Measurement Of Selected Antiepileptic Drugs Level And Quality Of Life Among Studied Population At Sultan Abdul Halim Hospital

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dc.contributor.authorNicholas, Dayana
dc.date.accessioned2018-01-10T02:27:53Z
dc.date.available2018-01-10T02:27:53Z
dc.date.issued2017-09
dc.description.abstractIn spite of well-established therapeutic drug monitoring (TDM) services in most of the major hospitals, the TDM for anti-epileptic drugs (AEDs) is still very challenging. Thus, the main aim of this research was to explore the provision of TDM services in the management of seizures and also to determine the clinical characteristics of responders and non-responders in relation to the attainment of therapeutic levels and appropriate Quality of Life (QoL) among children, adults and geriatrics who had different type of seizures. This study has provided the estimation of seizure prevalence, characteristics of seizures; serum drug concentrations (SDCs) of AEDs recorded by executing a hospital based prospective study. In phase-I study, series of results as sub grouped patients in A, B, C and D to response to AEDs verses therapeutic ranges were observed with significant variables using binary logistic regression analysis and was found that age group is the predictive variable that affected the response to AEDs among adult and geriatrics whose B exponential value shown -0.064. Patients who did not respond to the AEDs from the study population were children [77 (68.7 %)], adults [67 (37.1 %)] and geriatric patients [12 (44.4 %)]. The one-way ANOVA test has identified with significant factors such as gender, duration of the frequency, family history of epilepsy; co-morbidities and adherence are more likely to cause non response to AEDs in children. Remarkable predictors’ namely female gender, co-morbidity, mono-therapy and breakthrough seizures were identified among adults. Predictors such as male gender, co-morbidity and break through seizures are identified in children. Sodium valproate was commonly prescribed mono-therapy and well utilized in children. Patients who gain weight were possibly on carbamazepine and sodium valproate therapy. Most of the patients in adult group between the age of 19-64 years and children between the age group of 1-18 years are at risk of receiving recurrent epilepsy strikes where these subjects shown with non-target ranges and not responded to AEDs. By phase-II study, the impact of seizures on quality of life (QoL) was evaluated using completely answered QOLIE-31 questionnaire in which males had the least score with regard to the medication effects domain (48.90±23.47) and cognitive functioning was the highest score (74.00±23.72). This research study helps the pharmacists to involve in effective counselling for patients as well as create more awareness on monitoring the SDCs and do safe recommendation on dose. Through this study, the clinicians can make safe drug prescriptions by understanding the precipitating factors that could affect the patient’s response to AEDs, therapeutic levels and medication effects that affect quality of life in adults. This study strongly recommends the effective treatment strategies and clinical decision support for appropriate monitoring for better clinical outcome and quality of life in patients and this study suggests more future research to support health care team.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/5351
dc.language.isoenen_US
dc.publisherUniversiti Sains Malaysiaen_US
dc.subjectThe attainment of therapeutic levelsen_US
dc.subjectand appropriate Quality of Lifeen_US
dc.titleMeasurement Of Selected Antiepileptic Drugs Level And Quality Of Life Among Studied Population At Sultan Abdul Halim Hospitalen_US
dc.typeThesisen_US
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