Medicine Possession Ratio of Antiepileptics in Pediatric Patients with Epilepsy in Queen Sirikit National Institute of Child Health

Abstract

Background : Medical treatment for pediatric patients who had epilepsy could be incomplete due to interrupted visits for antiepileptic prescriptions or coverage restrictions by health insurance schemes. Studies on continuity in the use of antiepileptics as measured by medicine possession ratio (MPR) were scarce.

Method : This study was a retrospective data analysis aiming for estimating the MPR of antiepileptics across insurance schemes and determining independent factors associated with variation in the MPR. The study patients were children with epilepsy who visited the study hospital and were prescribed with antiepileptics during 1 January 2012 to 31 December 2017. The mean MPR for each insurance scheme were calculated and analyzed factors associated with the MPR, using a linear regression.

Results : On average, the MPR of antiepileptics during six years of the study period was 63.3% (SD, 29.9%). Patients covered by ‘Disability Scheme (DS)’ and those in transition from Universal Coverage Scheme (UCS) to DS had a higher MPR than other schemes. Based on linear regression analysis, patients under the DS had 7.0 percentage (%) point higher in MPR than those under the UCS with cross-zone referrals (p<0.05). Patients receiving the antiepileptics for a duration of five years or above had a higher MPR than those with the window periods between the first and the last antiepileptic prescriptions of up to one year by 27.1% points (p<0.05). Patient’s domicile was not statistically associated with the antiepileptic MPR (p=0.766).

Conclusions : Pediatric patients with epilepsy varied with respect to MPR, dependent on health insurance schemes and window periods between the earliest and latest prescriptions of the antiepileptic prescriptions.