# A Survey on the Awareness of Epilepsy Treatments in Community Pharmacies

## TL;DR

This study surveyed community pharmacies in Hiroshima to assess their awareness and communication about epilepsy treatments and drug interactions.

## Contribution

The study provides new insights into the current practices and gaps in pharmacy-physician communication regarding epilepsy treatment in community pharmacies.

## Key findings

- Only 50% or less of pharmacies provided feedback to physicians about drug interactions and seizure-threshold-lowering drugs.
- Generic drug switching was common (73%), but prior confirmation before switching was rare (5%).
- Pharmacies with weekly patient care were more likely to provide information on new medications and switch to generics.

## Abstract

Background: For effective epileptic seizure management, pharmacies need to provide physicians with information regarding drug-drug interactions, drugs that lower seizure thresholds, and switching to generic drugs. The aim of the study was to clarify the actual situation of information provision from pharmacies to physicians and investigate awareness of epilepsy treatment in community pharmacies.

Methods: A survey targeting all pharmacies (1,512 pharmacies) belonging to the Hiroshima Prefectural Pharmacists Association was conducted from October 7, 2023, to November 30, 2023. The survey investigated the dispensing status of antiseizure medication (ASM) prescriptions and the feedback rate to physicians regarding drug interactions, seizure-threshold-lowering drugs, and switching to generics. We also evaluated the relationship between the frequency of patient care, the status of information provision, and switching to generic medications.

Results: Of the 197 pharmacies that responded, 181 (92%) had experience with ASM prescriptions. Ninety-five pharmacies (48%) provided feedback to physicians on interactions with newly prescribed ASMs. Precautions for interactions between new drugs and ongoing ASMs were addressed in 98 pharmacies (50%). Additionally, 86 pharmacies (44%) provided feedback on new drugs that lower the seizure threshold. Generic switching occurred in 143 pharmacies (73%). Information for physicians was provided via medicine notebooks in 160 cases (81%), while preconfirmation was conducted in only 10 cases (5%). Pharmacies providing patient care at least once a week were more likely to provide information about newly prescribed concomitant medications (p = 0.04), but no significant difference was found in other cases. They were also more likely to switch to generic drugs (p < 0.01), but there was no difference in providing information to physicians before confirmation.

Conclusions: Feedback rates to physicians regarding interactions requiring precautions and threshold-lowering drugs were 50% or less, and prior confirmation when switching to generic drugs was rare. Further promotion of hospital-pharmacy information sharing is needed for more appropriate seizure management in patients with epilepsy.