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Treatment patterns and adverse events of antiseizure medications among adult patients with epilepsy: a single centre observational cross-sectional study in Northern Sri Lanka

2026-01-01T00:00:00Z

Title: Treatment patterns and adverse events of antiseizure medications among adult patients with epilepsy: a single centre observational cross-sectional study in Northern Sri Lanka Authors: Thiyahiny, S.N.; Yalini, G.; Ajantha, K. Abstract: Background: Antiseizure medications (ASMs) are essential for seizure control, but they are also associated with a range of adverse events that may affect treatment outcomes. Objective: This study aimed to evaluate the treatment pattern and adverse events of ASMs among adult patients with epilepsy who were followed up at a tertiary-care hospital in Northern Sri Lanka. Methods: A descriptive cross-sectional study was conducted among adult patients on ASMs for ≥ 3 months who were receiving follow-up at Teaching Hospital Jaffna. Data were collected over four months using a pretested interviewer-administered questionnaire. Chi-square test and logistic regression were performed to determine the significance between groups and the association of independent variables, respectively. A p-value of ≤ 0.05 was considered statistically significant. Results: Data from 213 participants was analysed. The mean age was 36.27 ± 0.92 years, and the male-to-female ratio was almost 1. Nearly two-thirds of participants (64.8%) were on dual or polytherapy. Older ASMs were predominantly prescribed (74.5%). A total of 333 adverse events were reported, giving a point prevalence of 68.5% and a rate of 1.6 adverse events per person. Sedation (27%), memory impairment (24%), and dizziness (21%) were the most common adverse events. Advancing age (adjusted OR (AOR): 4.3, 95% CI 1.87 to 10.29, p < 0.001), early onset of epilepsy (AOR: 0.35, 95% CI 0.14 to 0.87, p = 0.023), and the use of multiple ASMs (AOR: 2.7, 95% CI 1.4 to 5.3, p = 0.003) were associated with the occurrence of adverse events. Carbamazepine, clobazam and valproic acid were significantly (p < 0.05) associated with one or more common adverse events. Conclusion: Most patients in this study received older antiseizure medications and polytherapy. A high burden of adverse events linked to antiseizure medications was also observed. Studies with larger samples are needed to determine the safety and efficacy of current practices and to plan treatment strategies to optimise the epilepsy care.

Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna

2026-01-01T00:00:00Z

Title: Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna Authors: Thenuka, K.; Kalki, P.; Nilukshika, U.; Saranja, N.; Sanchayan, K. Abstract: Epilepsy affects both adults and children and requires long-term medication control, with antiepileptic drugs as the first-line therapy. Good adherence to anti-epileptic medication (AEM) is essential for optimal treatment outcomes, particularly in children who may not require lifelong treatment. Caregiver awareness and knowledge play a critical role, as non-adherence to AEM has become a significant concern. This hospital-based descriptive cross-sectional study aimed to assess caregiver knowledge and medication adherence among caregivers of children with epilepsy attending the Paediatric Clinic at Teaching Hospital Jaffna. A total of 127 caregivers aged over 18 years, caring for children under 14 years with epilepsy, participated in the study, with a response rate of 97%. Data were collected using a knowledge questionnaire (score range: 0–13), numerical, and the MARS-5 (Parent Version) adherence scale (score range: 6–30), categorized into good and poor adherence. Statistical analysis included Chisquare or Fisher’s exact tests, Mann–Whitney U, and Kruskal–Wallis tests, with significance set at p ≤ 0.05. Most caregivers were parents (96%). The mean caregiver knowledge score was moderate (8.43/13). Good adherence was significantly associated with higher knowledge scores, regular clinic attendance, fewer seizure episodes, family history of epilepsy, parental factors, and awareness of medication side effects. Higher knowledge levels were associated with being married, having a middle household income, a better understanding of epilepsy, and awareness of AEM side effects. The findings highlight the need for ongoing caregiver education and consistent support from healthcare professionals to ensure effective epilepsy management in children.

Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka

2026-01-01T00:00:00Z

Title: Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka Authors: Guruparan, Y.; Thiyahiny, S.N.; Kumar, R.; Gowry, S.; Shalini, S.R. Abstract: Objectives This study explores perceptions of inhaled medications among patients with asthma at an outpatient tertiary care setting in Northern Sri Lanka. Design A descriptive qualitative research design was used to gather data through focus group discussions (FGDs) that were transcribed, translated, manually coded and thematically analysed using Braun and Clarke’s six-step approach. Setting The study was conducted at an outpatient medical clinic at a tertiary care centre in Northern Sri Lanka. Participants Six FGDs were carried out among adult patients with asthma who had been on inhaled medications for at least 3 months. Participants were selected by maximum variation sampling, with each FGD consisting of 6–10 participants. Results 51 participants between the ages of 20 and 71 years were recruited; 36 (70.6%) were female, and about a fourth had primary education or less. Seven subthemes were drawn out and organised into three overarching themes: (1) inhaler hesitancy; (2) fear-driven adherence and (3) conviction at last. Most participants were initially reluctant to use inhalers, primarily due to concerns about dependency and side effects, often influenced by opinions of family members. They delayed use until they experienced severe symptoms, with some describing nebulisation, hospitalisation and fear of death as turning points. Symptom alleviation and improved quality of life led to better adherence. Conclusions Delays in inhaler use could lead to poor asthma control and outcomes. As many patients reported using their inhalers more consistently after an exacerbation or hospitalisation, asthma education programmes, involving both patients and family members, could address context-specific beliefs and misconceptions to promote early and sustained adherence to inhaled medications.

Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data

2024-01-01T00:00:00Z

Title: Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data Authors: Thiyahiny, S.N.; Gajanthan, R.; Janahan, R.; Sujanitha, V.; Sivansuthan, S.; Kesavan, R. Abstract: Abnormal lipid profile is considered as an important contributor to cardiovascular diseases among South Asians. Sri Lanka is a multiethnic South Asian nation and differences in ethnicity may influence the pattern of lipid profile. The aim of this paper is to analyse the lipid levels of healthy adults of a predominantly Sri Lankan Tamil population in the Northern Sri Lanka and compare it with the lipid levels of different ethnic groups reported in the literature. It was a cross-sectional analysis of secondary data of 500 healthy adults who were the controls of a larger study on the lipid profile of diabetic and non-diabetic patients. Cut-off values for desirable lipid levels used in this study were determined according to national and international guidelines. Chi-squared test, independent t-test/ Mann– Whitney U-test and one-way analysis of variance were used to determine the statistical significance and a p-value <0.05 was considered significant. The majority (61.4%) were women and the mean age was 54.8±12.6 years. Mean lipid levels were within normal range except HDL cholesterol (HDL-C) in women (46.6± ±10.6 mg/dL). Desirable lipid levels were observed in majority of the participants (58%- 80%) except HDL-C among women (32%). Half of the study population had a desirable total cholesterol: HDL-C ratio (50.8%). Significant difference between men and women was observed for HDL-C (p<0.05). The HDL-C levels and total cholesterol: HDL-C ratio of Jaffna population were comparable to those of South Asian populations. Further studies are needed to determine the clinical implication of these observations.