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KMID : 1031120210110010072
Journal of Epilepsy Research
2021 Volume.11 No. 1 p.72 ~ p.82
Survey on Antiepileptic Drug Therapy in Patients with Drug Resistant Epilepsy
Sunwoo Jun-Sang

Jo Hyun-Jin
Kang Kyung-Wook
Kim Keun-Tae
Kim Dae-Young
Kim Dong-Wook
Kim Min-Jee
Kim Sae-Yoon
Kim Woo-Jun
Moon Hye-Jin
Park Ha-Ree
Byun Jung-Ick
Seo Jong-Geun
Lim Sung-Chul
Chu Min-Kyung
Han Su-Hyun
Hwang Kyoung-Jin
Seo Dae-Won
Abstract
Background and Purpose: Individualized anti-epileptic drug (AED) selection in patient with epilepsy is crucial. However, there is no unified opinion in treating patients with drug resistant epilepsy (DRE). This survey aimed to make a consolidate consensus with epileptologists¡¯ perspectives of the treatment for Korean DRE patients by survey responses.

Methods: The survey was conducted with Korean epilepsy experts who have experience prescribing AEDs via e-mail. Survey questionnaires consisted of six items regarding prescription patterns and practical questions in treating patients with DRE in Korea. The research period was from February 2021 to March 2021.

Results: The survey response rate was 83.3% (90/108). Most (77.8%) of the responders are neurologists. The proportion of patients whose seizures were not controlled by the second AED was 26.9%. The proportion of patients who had taken five or more AEDs is 13.9%, and those who are currently taking five or more AEDs are 7.3%, of which 54.5% and 37.9% reported positive effects on additional AED, respectively. The majority (91.1%) of respondents answered that the mechanism of action was the top priority factor when adding AED. Regarding data priority, responders considered that expert opinion should have the top priority, followed by clinical experiences, reimbursement guidelines and clinical evidence. Responders gave 64.9 points (range from 0 to 100) about overall satisfaction on reimbursement system of Health Insurance Review and Assessment Service for AED.

Conclusions: This study on AED therapy for DRE patients is the first nationwide trial in Korean epilepsy experts. In five drug failure, the top priorities on AED selection are mechanism of action and expert opinion. These findings might help to achieve consensus and recognize the insight on optimal therapy of AED in DRE.
KEYWORD
Antiepileptic drugs, Drug resistant epilepsy, Epilepsy, Seizures
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