Effect of pharmaceutical care program on depression among women with epilepsy: A randomized controlled trial (IPHIWWE study) (Losada-Camacho M. Epilepsy Behav. 2022 Apr)
Epilepsy: The Story
In a randomized controlled trial conducted in Bogota, Colombia, researchers investigated the effects of a pharmaceutical care program on depression in women with epilepsy, compared to usual care.
Why it’s Important
Depression is the most common comorbidity in patients with epilepsy. It affects 11-62% of patients, but is twice as prevalent in women than in men. Depression in epilepsy is associated with reduced adherence to medication, poorer seizure control and sleep quality, higher rates of adverse events resulting from anti-seizure drugs (ASDs), increased risk of suicide, and higher healthcare costs. It is also strongly associated with lower quality of life in patients, regardless of seizure frequency.
The exact etiology of depression in epilepsy is still being explored, but studies have shown that psychosocial, neurobiological, and disease-related factors play a role in its development. Psychosocial factors include complications of epilepsy such as employment issues, financial stresses, social isolation, and stigma. Neurological factors include the shared structural/functional abnormalities in different brain regions in patients with epilepsy and depression. Finally, disease-related factors include frequency and control of seizures and side effects of antiepileptic drugs.
Controlling seizures, adhering to ASDs, limiting ASD side effects and adjusting to life with epilepsy can all improve symptoms of depression in patients with epilepsy. Therefore, creating a pharmaceutical care program that addresses these factors may help reduce the impact of depression on patients.
In this study, WWE were randomized to either the intervention (receiving a pharmaceutical care program) or the control group (receiving usual care in the specialist clinic).
All participants were assessed at baseline and six months. Symptoms of depression were evaluated using the Center for Epidemiologic Studies Depression (CES-D) scale, and health-related quality of life was assessed using the Quality Of Life In Epilepsy-31 inventory (QOLIE-31).