# Evaluation of prescribing patterns of sodium valproate in neurological disease patients: a quasi-experimental pretest–posttest design study

## TL;DR

This study shows that pharmacist counseling improves how sodium valproate is prescribed and used in neurological disease patients.

## Contribution

The study demonstrates that pharmacist-led educational interventions significantly improve prescribing patterns and medication adherence for sodium valproate.

## Key findings

- After a 3-month pharmacy educational intervention, the tendency toward antipsychotic combination decreased significantly.
- Medication adherence increased from 8.3% to 67.1% following the intervention.
- Drug-drug interactions and medication errors related to frequency and dosage were reduced.

## Abstract

The well-known anti-seizure medication, sodium valproate, is used to treat epilepsy, bipolar disorder, and other mental health conditions.

This study aimed to determine how pharmacist counseling intervention affected the prescribing patterns and usage of sodium valproate in patients with neurological diseases.

Patient prescriptions were analyzed in a quasi-experimental pretest–posttest design research, at baseline and after three months of pharmacy educational intervention. Medical history, drug-drug interactions, antipsychotic combinations, medication errors, and dosages were among the information gathered.

The reviewed prescriptions observed trend towards antipsychotic combination, 15 (2.5%) prescriptions had five medications, while 18 (3%) contained four, 169 (28.2%) containing three, 329 (54.8%) containing two, and 69 (11.5%) containing one, antipsychotic. Of the reviewed prescriptions, 6% had possible drug-drug interactions. However, following a 3-month pharmacy educational intervention, the tendency toward antipsychotic combination decreased significantly to 262 (52%) with prescriptions for 2 antipsychotics and 163 (32.3%) with 3 antipsychotics. Likewise, the decreases in medication errors related to frequency and dosage were 8 (1.6%) vs. 29 (4.8%) and 6 (1.2%) vs. 35 (5.8%), compared to baseline respectively. Additionally, medication adherence was raised significantly (p < 0.000) from 50 (8.3%) to 338 (67.1%) after the intervention.

More precise regulations should be placed on sodium valproate prescription patterns and usage, throughout implemented pharmacist initiative in patients counselling, provision of health education and therapeutic monitoring to improve health-related quality of life.

This study was registered on clinicaltrial.gov with an identification code NCT05830981. https://classic.clinicaltrials.gov/ct2/show/NCT05830981 (First Posted: April 26, 2023).

The online version contains supplementary material available at 10.1186/s12913-025-12483-5.

• Sodium valproate is used to treat neurological diseases.

• For individuals with neurological disorders, routine pharmacist assessments of medication regimens are crucial to identifying and managing any possible drug-related issues.

• In patients with neurological diseases, a pharmacist-led educational intervention markedly enhanced the prescription pattern and usage for sodium valproate, medication adherence, and disease control.

The online version contains supplementary material available at 10.1186/s12913-025-12483-5.