Abstracts

Rationale: The University of Kansas Health System Level 4 Comprehensive Epilepsy Center provides a multidisciplinary team approach to the diagnosis and treatment of epilepsy. Epilepsy management is challenging due to the need for individualized treatment plans and the inherent complexity of care. With over 30 anti-seizure medications available, pharmacists significantly contribute to identification, prevention, and resolution of drug-related problems in epilepsy care. Studies have shown that pharmacist-led interventions result in reduced drug-related problems and improved patient outcomes^1-2. Furthermore, pharmacists’ involvement in care teams has been associated with reduced healthcare costs, fewer hospitalizations, improved medication safety, and more timely access to care¹. The study objective was to identify and describe the role of the clinical pharmacist within a Level 4 Epilepsy Center.


Methods: Referrals to the clinical pharmacist made by epilepsy providers from September 19, 2022 to September 19, 2023 were reviewed. Referrals were dichotomized to clinical or medication access related questions. Clinical referrals included drug interaction assessments, comprehensive medication reviews, patient education, therapeutic drug monitoring, adverse drug reaction management, and drug information questions. Medication access referrals included investigation of antiseizure medication coverage (completion of insurance prior authorization, copay support, patient assistance) and drug availability.


Results: In total, 550 referrals were placed during the study period, of which 244 (44%) were clinical and 304 (55%) were medication access. There were 72 clinical recommendations (30%) by the pharmacist to modify or change therapy due to significant drug interactions, lack of drug efficacy, adverse drug events, non-adherence, or dosage problems. The primary medication access referral was for pharmacy benefits investigation, of which 96 patients transitioned to use the integrated health-system retail pharmacy due to cost, drug availability, and accessibility. There were 24 medication access recommendations (8%) to modify or change therapy to resolve access-related barriers, including cost-effective treatment options for uninsured patients, formulary alternatives based on insurance restrictions, and change in drug formulation due to drug availability or shortage.


Conclusions: Clinical pharmacists play a multifaceted role within an epilepsy clinic setting to ensure the safe and effective use of medication. Our results underscore the need for further studies to assess patient outcomes and benefits of following pharmacist interventions in epilepsy care and begins to establish a foundation for continued expansion of clinical pharmacist integration into level 4 epilepsy centers for improved comprehensive care.

References:
¹ Bott AM, Collins J, Daniels-Costa S, et al. Clinical Pharmacists Improve Patient Outcomes and Expand Access to Care. Federal Practitioner. 2019;36(10):471-475.
² Dalton K, Byrne S. Role of the pharmacist in reducing healthcare costs: current insights. Integr Pharm Res Pract. 2017;Volume 6(6):37-46.



Funding: None