Enhancing the way epilepsy is managed by engaging community pharmacists

The University of Washington's School of Pharmacy announced on Thursday, Sept. 12, a collaboration with global biopharmaceutical company UCB to improve access to care for people living with epilepsy. This interdisciplinary project will explore ways in which community pharmacists can better support people living with this neurological disorder.

The roughly 3.4 million people nationally and 75,000 people in Washington state who live with epilepsy often get fragmented and uncoordinated healthcare and community services.

"For the growing population of people living with epilepsy, this fragmentation of resources makes it harder to manage multiple co-existing health conditions and take anti-seizure drugs," said Steve White, professor and chair of the UW department of pharmacy, and a global expert on epilepsy. "And given the importance of medication adherence to manage epilepsy, poor adherence can have profound effects including injury, hospitalization, even unexpected death."

The project is led by White; Jennifer Bacci, Assistant Professor, department of pharmacy; Andy Stergachis, Associate Dean for Research, UW School of Pharmacy; and Sabra Zarâa, CHOICE Institute Ph.D. student. The effort builds upon a funding grant from the UW Population Health Initiative announced earlier this year.

Epilepsy is a complex and devastating disease in which patients experience spontaneous and recurrent seizures. This condition can impair daily routines, such as driving and working, which can often result in substantial socioeconomic disparities. Medications to treat the condition can be associated with serious side effects, and the seizures themselves can lead to on-going health challenges.

"Community pharmacists are among the most accessible healthcare providers for many in Washington state, and have extensive knowledge of drug therapy as well as the ability to support people in managing complex medication regimens, yet are seldom leveraged to close the gaps in epilepsy care," said Bacci. Moreover, "community pharmacists educate patients about their disease, ensure dosing accuracy, monitor for side effects and drug interactions, and encourage medication adherence."

At a population level, community pharmacists collaborate with other healthcare providers and assess medication use patterns and patient outcomes data to ensure medications are used effectively, safely and in a cost-effective manner. No models exist for engaging community pharmacists in population health approaches to epilepsy care.

"The UW Population Health Initiative seeks to accelerate new collaborations between diverse disciplines to find innovative solutions to the complex challenges society faces," said Ali Mokdad, the UW's chief strategy officer for Population Health and professor of Health Metrics Sciences. "We are excited to support the UW and UCB in bringing together the expertise and resources of the public and private sectors to develop a novel approach to increasing access to care for people living with epilepsy."

The team will develop an intervention by conducting a needs assessment, including interviewing stakeholders and performing a literature review. They will (1) identify best practices to address the needs of persons living with epilepsy and their caregivers; (2) develop a community pharmacy intervention using a stakeholder driven and consensus building approach; and (3) evaluate the acceptability, appropriateness, feasibility and potential effectiveness of the intervention.

"Community pharmacists are increasingly at the front line of healthcare delivery in the US." Said Mike Davis, Head of U.S. Neurology at UCB. "With these tools to facilitate better conversations with their community living with epilepsy they can play an important role in ensuring that more people living with epilepsy get to the right treatment at the right time. The University of Washington is doing great work in this area and UCB is proud to collaborate with them on this initiative."

Other members on the project team are John Miller, UW Medicine, Neurology; Edward Novotny, UW Medicine, Neurology and Seattle Children's Hospital; Bryan Weiner, UW departments of Global Health and Health Services; Matt Schumacher, UCB, Head Neurology Healthcare Strategy; Lawford Ricafort, UCB, Neurology Ecosystem Lead—Pacific West; and Grant Simic, UCB, Population Health Partner.