Antiseizure Medication Prescribing Patterns and Health-Related Quality of Life in Epilepsy: A Prospective Cross-Sectional Study from Western India

Abstract

Abstract Background Epilepsy is a chronic neurological disorder associated with significant clinical and psychosocial burden. Antiseizure medications (ASMs) are the mainstay of epilepsy treatment; however, Indian data on prescribing patterns and quality of life (QoL) remain limited. This study aimed to evaluate drug utilization patterns in epilepsy and to assess health-related QoL using the Quality of Life in Epilepsy Inventory-10-P (QOLIE-10-P) scale. Methods A prospective cross-sectional study was conducted from October 2024 to January 2025 at a tertiary care hospital in Gujarat, India. Adult patients (≥ 18 years) diagnosed with epilepsy as per the International League Against Epilepsy criteria were enrolled. Demographic and clinical data were collected, prescribed daily doses were compared with the World Health Organization (WHO)-defined daily doses, and QoL was assessed using the QOLIE-10-P questionnaire. Results Among 150 patients, males predominated (66.67%), and most were aged 31 to 60 years. Focal epilepsy was the most common type (46.67%). A total of 253 ASMs were prescribed, with levetiracetam (30.31%) and clobazam (25.59%) being most frequently used. Monotherapy (114 ASMs) was prescribed to 83 (55.33%) patients, whereas dual therapy (87 ASMs) and triple therapy (52 ASMs) were used in 45 (30%) and 22 (14.66%) patients, respectively, with 46.67% of overall patients had seizure-free period. Prescriptions showed adherence to essential medicine guidelines, with 76.37% aligned with the National List of Essential Medicines and 50.78% with the WHO Essential Medicines List. Most ASMs were prescribed within WHO-defined dose ranges. The mean QOLIE-10-P score (33.5 ± 1.19) indicated reduced QoL, with significant differences based on residence and education level. Psychological and sociodemographic factors, particularly depression, anxiety, education, and residence, were significant predictors of QoL, whereas clinical epilepsy-related factors showed limited influence. Conclusion Rational prescribing with increasing use of newer ASMs was observed. Individualized, patient-centered care incorporating psychosocial support is essential to improve QoL and long-term outcomes in epilepsy.