title: Frequent seizures and polytherapy can impair quality of life in persons with epilepsy.
abstract: BACKGROUND
  Careful evaluation of pharmacotherapy, seizure control and quality of life (QOL) are helpful in improving epilepsy care but such data are relatively meager from developing countries.
  
  
  OBJECTIVE
  To audit pharmacotherapy, seizure control and QOL in persons with epilepsy and to identify factors associated with impaired QOL.
  
  
  METHODS
  The study was carried out using a cross-sectional design in the setting of a tertiary care epilepsy center in India. Persons with epilepsy with > 12 months follow-up at this Center and aged > 16 years were eligible for enrollment. Persons with other disabilities or pregnancy were excluded. Subjects were interviewed with a standard questionnaire and an adapted version of Quality of Life in Epilepsy - 31 (QOLIE-31). Data pertaining to treatment at the time of referral to this center was extracted from medical records.
  
  
  METHODS
  Chi-square test, analysis of variance and multiple regression analysis were carried out for statistical significance.
  
  
  RESULTS
  One hundred and twelve patients with epilepsy (59 males, mean age 31.2+/-10.7 years) were included. Forty-seven (42%) persons had Generalized Epilepsy (GE) and 65 persons (58%) had Localization-Related Epilepsy (LRE). At entry 24 persons (21.4%) were not on treatment and 59 persons (64.8%) had frequent seizures. At last follow-up 64 persons (57.1%) were seizure-free, 83 persons (74.1%) were on monotherapy and 29 were (25.9%) on polytherapy. Cost of drug at entry was INR 2276 (monotherapy) and INR 3629 (polytherapy) (45 INR = 1 USD). At the time of last follow-up, it was 1898 and 4929 respectively. QOLIE-31 Total Score (TQOL) ranged from 22.6 to 94.4 (mean 68.0 +/- 15.8). Multiple regression analysis showed significant correlation between low TQOL score and polytherapy (P=0.002) and occurrence of one or more seizures per month (P=0.001).
  
  
  CONCLUSIONS
  Frequent seizures and polytherapy are associated with lower QOL in persons with epilepsy.
authors.affiliation: Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. sanjeev@sctimst.ker.nic.in
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Thomas
authors.forename: Samuel
authors.initials: S
authors.lastname: Koshy
authors.forename: C R Sudhakaran
authors.initials: CR
authors.lastname: Nair
authors.forename: Sankara P
authors.initials: SP
authors.lastname: Sarma
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000191:economics; D003430:Cross-Sectional Studies; D016527:Drug Costs; D004359:Drug Therapy, Combination; D004829:Epilepsy, Generalized / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D000927:Anticonvulsants