Abstracts

Rationale:
Epilepsy is a complex spectrum of seizure disorders. Pharmacotherapy remains the first-line treatment for epilepsy, and anti-seizure drugs, either alone or combined with others, are often required for the patient with difficult to control, or refractory epilepsy. Community pharmacists are easily accessible and have an extensive training in pharmacotherapy, health education and chronic disease management; however, little is known about their contributions to epilepsy care. The objective of this scoping review was to identify patient care services or interventions that community pharmacists have provided to people living with epilepsy and/or their caregivers.  
Method:
Pubmed/MEDLINE and EMBASE were searched for articles that were: (1) written in English, (2)  published in 1985 or later, (3) a peer-reviewed empirical study or practice report, and (4) described an intervention provided by a pharmacist for people with epilepsy and/or their caregivers in an outpatient pharmacy setting. The abstracts and full text, when necessary, were reviewed by two investigators to assess eligibility. Data were extracted from each article by two investigators using a standardized abstraction form based on the pharmacist patient care services intervention reporting (PaCIR) checklist. Data elements of interest included components of service, mode of service delivery, frequency, number and duration of sessions for the service, roles and responsibilities of the community pharmacist, type of community pharmacy, outcomes and measures evaluated along with data sources, and findings and results.  Risk of bias was not assessed due to the descriptive nature of the review.
Results:
Eleven articles were included, seven of which reported services conducted in the United States. The most common service reported was medication management (n=7) followed by education and counseling (n=3). Pharmacists provided medication management services either individually using point-of-care tests to monitor blood levels of medication, or as part of a multidisciplinary team involving neurologists, healthcare providers, and social workers, providing face-to-face patient care, including interviewing each patient, performing neurological assessment and mental status evaluation, and ordering lab tests per a clinical protocol. Most interventions were evaluated using observational designs (n=5) or did not have an evaluation component (n=4). 
Conclusion:
This scoping review provides examples of community pharmacists providing care to people living with epilepsy that extend beyond dispensing medications. Findings demonstrate that there is little published evidence on community pharmacists’ contributions to epilepsy care.  Further, findings suggest opportunities for further exploration and innovation as this review serves as the first step in a project that seeks to develop a stakeholder-driven community pharmacist integrated population health intervention for people living with epilepsy.
Funding:
:University of Washington Population Health Initiative and UCB, Inc.