Prevalence of Anti-epileptic Drugs Polypharmacy and Associated Factors among Epileptic Patients in Hiwot Fana Specialized University Hospital, Harar, Ethiopia

Background: Every newly diagnosed patient with epilepsy should take appropriate monotherapy based on the seizure type and the epilepsy syndrome. Anti-epileptic drugs (AED) polypharmacy did not necessarily improve seizure outcomes and could increase the propensity for side effects. This study evaluates the prevalence of AED polypharmacy and its associated factors in Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Method: ology A hospital-based cross-sectional study was conducted from April to March 2018. Patient chart review and an interview were made with selected epileptic patients and analyzed by using Stata corp version 14 software. A logistic regression model was fitted to identify the contribution of selected independent variables to AED polypharmacy. The results were presented using an adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) and, a p-value of <0.05 was considered as a cut-off point for declaring significance. Results: A total of 252 epileptic patients were included in the analysis with a mean age of 30.4 ( + SD7.8). More than half of the respondents were male (54.0%) and rural residents (52.8%). About 49% had 15 to 25 years duration of illness, and more than half had 3 to 5 years duration of treatment (50.8%). The most common type of seizure diagnosed was Generalized Tonic-Clonic Seizure (GTCS) (49.2%), while the most common type of AED prescribed was Phenobarbitone (PHB) (69.8%). The prevalence of antiepileptic polypharmacy was 24.2%. The most frequently prescribed combination therapy was phenobarbitone with carbamazepine (15.5%) Place of residence (AOR=3; 95% CI: 1.1-8.3), long duration of illness (AOR=5.8; 95% CI: 1.1- 30.3), drug non-adherence (AOR = 0.02; 95% CI: 0.01- 0.06), and complaint of side effect (AOR=3.4; 95% CI: 1.1-10.8), had a significant association with antiepileptic polypharmacy. Conclusion: The prevalence of AED polypharmacy was high among the study participants. The physicians should choose the drugs based on the seizure type and epilepsy syndrome to maintain patients on the appropriate mono-therapy.