Fellow Chungnam National University Hospital Daejeon, Taejon-jikhalsi, Republic of Korea
Rationale: Since pharmacologic agents are the mainstay of epilepsy treatment, drug compliance is one of the most important factors in seizure control. Levetiracetam has been widely used in the treatment of epilepsy because of its broad-spectrum efficacy, unique mechanism of action, and fewer adverse effects. Once-daily levetiracetam dose has been proven to have the same efficacy as that of an immediate-release formulation. Reduced number of doses may improve drug compliance and patient satisfaction. The aim of this study was to assess drug compliance and patient satisfaction, by changing immediate-release formulations to extended-release formulations. Methods: Adolescent patients diagnosed with epilepsy, who were taking levetiracetam from 2013 to 2020, were included in this study. Compliance charts were reviewed retrospectively. We compared the frequency of seizure occurrence with the frequency of skipping medicine and adverse effects before and after changing formulation. Additionally, alterations in subjective compliance and satisfaction were investigated. Results: Among 482 patients taking levetiracetam, 46 patients were included in this study. The average age of the included patients was 16.7±3.3 years. Out of the 46 patients, 32 (69.6%) patients had focal epilepsy and 14 (30.4%) had generalized epilepsy. Twenty-seven of 46 (58.7%) patients were seizure-free. There was no significant difference in the average seizure frequency (p=0.702) before and after switching the formulation. Differences in seizure frequency did not depend on sex, drug dose, and epilepsy type. Out of the 46 patients, four (8.7%) had adverse effects such as dizziness, drowsiness, and dyspepsia. One had suicidal ideas and had to switch to the previous formulation. Twenty-six of 46 patients mentioned about compliance, and objective compliance based on chart records was not different before and after changing the formulation (p=0.153). However, 13 of 26 (50%) patients expressed better compliance with the extended-release formulation. Of 26 patients, 25 (96.2%) were satisfied with the new formulation. The most common reason for not taking medicine was forgetfulness (9 of 10). Conclusions: Our study shows that extended-release levetiracetam has efficacy similar to that of immediate-release formulations. The reduced number of medication doses improved patient satisfaction and medication compliance. Funding: Please list any funding that was received in support of this abstract.: None.