Abstracts

Rationale: Pharmacist services in the care of patients with epilepsy (PWE) has continued to expand beyond that of dispensing and is evolving globally. The objective of this study was to identify and describe the types of pharmacist services that have been reported in the care of PWE.

Methods: A literature search was conducted through June 2021 in PubMed/Medline using the terms “epilepsy” and “seizure” in combination with “pharmacist” and “pharmaceutical care.” Articles were included if they were written in English and described pharmacist roles in the care of a PWE. Pharmacist activity/interventions were then categorized by themes.

Results: Thirty-eight articles from 1978-2021 were included. Pharmacy services were described in Australia, Brazil, China, Columbia, Germany, Israel, Japan, Malaysia, Nigeria, Netherlands, Norway, Palestine, Paraguay, Saudi Arabia, South Africa, Sweden, Thailand, UK, and US and in the following settings: outpatient clinic (n=16), hospital/nursing home (n=10), community pharmacy (n=7), research (n=2), telehealth (n=2), and home care (n=1). The majority of studies were focused on pharmacist interventions in adult patients with epilepsy. Only a handful of studies focused on pediatrics, elderly/nursing home patients and women with epilepsy. The types of articles included trials comparing interventions utilizing pharmacists with another comparator group (n=8), trials comparing outcome measures pre- and post- interventions utilizing pharmacists (n=10), retrospective and prospective observational cohort studies utilizing pharmacist interventions (n=16) (with 5 of these studies providing summary descriptions only), survey studies (n=3), and focus groups (n=1). Seven major themes were identified: 1) provision of pharmaceutical care in a team-based care model with direct collaboration between providers where the pharmacist performs various activities including obtaining medication histories, performing medication review, identifying medication-related problems (MRPs), working jointly with other providers to develop care plans, and providing patient education and counseling (n=9); 2) provision of pharmaceutical care independently including obtaining medication histories, performing medication review, identify MRPs, and providing education and counseling outside a direct collaborative team-based model (n=7); 3) patient education and counseling (n= 4); 4) performing therapeutic drug monitoring (TDM) and performing interventions based on TDM when appropriate (n=4); 5) directly managing or dosing antiseizure medication therapy (n=3); 6) research-based roles (n=3); and finally 7) acting as patient advocate and/or healthcare partner.

Conclusions: An array of pharmacist services and activities in the care of PWE globally are described in the literature. The majority of studies describe a collaborative team approach with the pharmacist working jointly with the epileptologist or other members of the epilepsy team. While it is encouraging to see the role of pharmacist in managing PWE continue to progress globally, there is a lack of studies describing pharmacists with expanded scope of practice who directly manage PWE and their antiseizure medications.

Funding: Please list any funding that was received in support of this abstract.: This study was unfunded.