5PSQ-144 The value of therapeutic adherence in the treatment of drug-resistant epilepsy

<h3>Background and Importance</h3> Cenobamate is a drug approved by the EMA (European Medicines Agency) on 26^thMarch 2021 as adjunctive therapy of seizures in adult patients with drug-resistant epilepsy who have not been adequately controlled with at least two antiepileptic drugs. The mechanism of action is not fully understood. The initial dose is 12.5mg/day which is increased to a dose of 200mg/day, according to the specialist prescriptions. <h3>Aim and Objectives</h3> The aim is to evaluate the drug use, therapeutic adherence and improvement of the quality of life (QdV) of patients referred to an Apulian local pharmacy to which the drug was dispensed, after having carried out prescription appropriateness assessments. <h3>Material and Methods</h3> Cenobamate’s disbursements made from September 2022 to May 2024 have been extrapolated from the company computer system. An anonymous questionnaire, based on the Morisky scale, has been used to assess the therapeutic adherence and QdV of patients treated with cenobamate. The data analysed are: patient characteristics (age, sex, type of epilepsy, polytherapy with other antiseizure drugs), compliance and therapeutic adherence. <h3>Results</h3> We have 34 patients with focal (or partial) structural, drug-resistant epilepsy treated with cenobamate, including one off-label prescription patient diagnosed with early childhood epileptic encephalopathy. 56% of patients under treatment are female, 44% male. The average age is 38.5years and 59% (30–50 years), 20% (18–30 years), 18% (&gt;50 years) and 3% (0–18 years), with onset of childhood pathology. To date, 28 patients of 34 are adherent to therapy, two suspended therapy for other comorbidities (chemotherapy, kidney problems), three have suspended it due to ineffectiveness and/or serious adverse reactions (confused state), one has never taken it. From the questionnaire, 20 patients show high adherence, one low and six intermediate. The patients undergoing polypharmacy are: nine who combine another antiepileptic drug, 12 who associate two, four who associate three and two patients four. Most patients are not autonomous in daily activities and do not lead a normal life. 71.4% of patients report an improvement in QdV with a reduction in epileptic episodes, while 25% despite being adherent to treatment do not report any improvement in QdV. <h3>Conclusion and Relevance</h3> Adherence to therapy underlines the efficacy and safety of the drug, supporting the excellent impact of this new therapeutic alternative. The high index of appropriateness highlights the monitoring activity of the pharmacist in new therapies in the area. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest