The Impact of a Pharmacist on Epilepsy

Introduction

About 3.4 million people nationwide have active epilepsy and pharmacists can ensure that epilepsy does not control their lives. Globally, an estimated 65 million people suffer from epilepsy, which causes recurring, unprovoked seizures, and is the world’s fourth most common neurological disorder.Epilepsy comes with its own series of comorbidities, such as learning disabilities, autism, anxiety, and depression.

The goal of treatment for epilepsy is to help patients lower their seizure rate to zero with minimal adverse events (AEs). Many patients with epilepsy continue to experience uncontrolled seizures despite taking multiple antiseizure medications. Despite the availability of more than 20 FDA-approved antiepileptic drugs for the treatment of epilepsy, treatment outcomes have remained relatively stagnant for the past 20 years.

Epilepsy is typically diagnosed following 2 unprovoked seizures or 1 unprovoked seizure with the likelihood of more that are not caused by a known and reversible medical condition. Most epilepsy cases manifest during childhood and frequently evolve in later years.

Many patients with epilepsy will experience multiple types of seizure along with symptoms of other neurological conditions. The disease is also common among individuals 55 years of age and older, with close to 1 million US adults in this age group diagnosed with the condition.

The William S. Middleton Memorial Veterans Hospital (WSMVH) in Madison, Wisconsin offers an epilepsy clinic each year to provide care for veterans. The multidisciplinary team involves the help of clinical pharmacy practitioners (CPP) and pharmacy residents who guide patients in understanding their medication regimen and the importance of medication adherence.

Although this clinic has been around for decades, the current group of health care workers sought to perform a study on the impact of pharmacists on patient outcomes.

Study Description

WSMVH created a single-center, retrospective, quality improvement project to evaluate pharmacists’ impact on the epilepsy clinic. Between October 2017 and June 2021, they performed a chart review of 446 patients seen by CPPs or pharmacy residents to assess the different types of interventions that occurred during the visits.

Some of the treatment interventions included:

• Medication initiations/discontinuations
• Dose changes
• Nonpharmacologic interventions (including education)
• Mental health screenings
• Consultations to other specialties placed
• Laboratory tests ordered

Key Findings

Early screening, detection, and treatment of comorbidities are essential in the care of epilepsy patients. Pharmacists have been a part of many treatment interventions throughout the years at the WSMVH epilepsy clinic, handling 43% of patients who came through the clinic. Overall, the addition of pharmacists to the health care team allowed more timely access to care for the patients.

Conclusion

Patients with epilepsy rely on medications to help them maintain a sense of normalcy in their daily lives. Pharmacists support these patients, as exemplified through this study. Epilepsy is a complicated disease that requires time and attention, and patients deserve the top level of care. Pharmacists are an essential cog in the machination that is epilepsy.

About the Author

Christina Nault is a 2025 PharmD candidate at the University of Connecticut.

Reference

Taube M, Kotloski R, Karasov A, Jones JC, Gidal B. Impact of Clinical Pharmacists on Access to Care in an Epilepsy Clinic. Fed Pract. 2022;39(Suppl 1):S5-S9. doi:10.12788/fp.0252