OBJECTIVES : To describe the outcomes of an interprofessional telehealth program for rural-dwelling patients with epilepsy in one United States (US) state.

METHODS : A pharmacist from an academic-based medication therapy management center provided comprehensive services, using video-conferencing technology and a telephonic follow-up consultation, to rural-dwelling patients with epilepsy in Illinois.Data were collected for participant demographics, number and types of prescribed seizure medications, comorbidities, drug-disease interactions, drug-drug interactions, adverse drug reactions, therapeutic duplications, dose-related safety concerns, labs or appointments needed, medication adherence, and medication utilization concerns, as well as recommendations made to resolve any issues identified. Descriptive data analysis was conducted as appropriate.

RESULTS : A total of 168 patients were included in this descriptive pilot study (51% male, mean age 28 ± 15 years). Most participants (94%) were prescribed at least one seizure medication (average 2 ± 1 medications per person), including benzodiazepines (n=89), lamotrigine (n=58), and levetiracetam (n=56). The majority (55%) had at least one comorbidity (average 1 ± 1 comorbidities per person), including mood disorders (n=49) and psychiatric disorders (n=26). Seventy-seven medications were not recommended for seizures, including selective serotonin reuptake inhibitors (n=18), second-generation atypical antipsychotics (n=17) and benzodiazepines (n=16). Participants (n=168) had at least one: drug-disease interaction (33%), drug-drug interaction (54%), adverse drug reaction (37%), therapeutic duplication (13%); other problems included: dose-related safety concerns (35%), and medication utilization concerns (13%). The majority reported never missing a dose in the previous month (70%). Of 71 participants asked, a limited number needed laboratory tests (n=30) or medical appointments (n=10).

CONCLUSIONS : Many medication-related problems were identified among this sample of patients with epilepsy, demonstrating the value of pharmacists in an interprofessional team. Further work should investigate why these medication problems exist, and seek to reduce their occurrence.