Community pharmacists’ role in caring for people living with epilepsy: A scoping review

Published:February 23, 2021DOI:


      • There are opportunities to engage community pharmacists in epilepsy care.
      • This review identified 12 articles about community pharmacist epilepsy services.
      • Medication management and education were the most commonly reported services.
      • Most services were evaluated using an observational design or were not evaluated.
      • There are opportunities to innovate community pharmacists’ role in epilepsy care.



      To identify and describe studies about pharmacist-provided services for people with epilepsy and their caregivers.


      PubMed/MEDLINE and EMBASE were searched for articles that were: (1) written in English, (2) published in 1985 or later, (3) a peer-reviewed empirical study or practice report, and (4) describing an intervention provided by a pharmacist for people with epilepsy and/or their caregivers in an outpatient pharmacy setting. The abstracts and full text, when necessary, were reviewed by two investigators to assess eligibility. Data were extracted from each article by two investigators using a standardized abstraction form based on the Pharmacist Patient Care Services Intervention Reporting (PaCIR) checklist. Data elements of interest included components of service, mode of service delivery, frequency, number and duration of sessions for the service, roles and responsibilities of the community pharmacist, type of community pharmacy, outcomes and measures evaluated along with data sources, and findings and results. Risk of bias was not assessed due to the descriptive nature of the review.


      Twelve articles were included, seven of which reported services conducted in the United States. The most common service reported was medication management (n = 7) followed by education and counseling (n = 4). One article described a care coordination documentation tool that could be used by pharmacists and physicians in epilepsy care. Most interventions were evaluated using observational designs (n = 5) or did not have an evaluation component (n = 4).


      This review provides examples of community pharmacists providing care to people living with epilepsy that extend beyond dispensing medications. Findings demonstrate that there is little published evidence on community pharmacists’ contributions to epilepsy care and suggest opportunities for further exploration and innovation. This review serves as the first step in a project that seeks to develop a stakeholder-driven community pharmacist integrated population health intervention for people living with epilepsy.


      ASM (anti-seizure medication), PaCIR (Pharmacist Patient Care Services Intervention Reporting), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), PWE (people living with epilepsy)


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      1. World Health Organization. Epilepsy,; 2020 [accessed 27 February 2020].

        • Zack M.M.
        • Kobau R.
        National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015.
        Morb Mortal Wkly Rep. 2017; 66: 821-825
        • England M.J.
        • Liverman C.T.
        • Schultz A.M.
        • Strawbridge L.M.
        Institute of medicine; board on health sciences policy; committee on the public health dimensions of the epilepsies.
        Epilepsy across the spectrum: promoting health and understanding. National Academies Press, Washington2012
      2. Centers for Disease Control and Prevention. Epilepsy Fast Facts,; 2018 [accessed 27 February 2020].

        • Koh H.K.
        • Kobau R.
        • Whittemore V.H.
        • Mann M.Y.
        • Johnson J.G.
        • Hutter J.D.
        • et al.
        Toward an integrated public health approach for epilepsy in the 21st century.
        Prev Chronic Dis. 2014; 11: E146
        • Thomas S.V.
        • Koshy S.
        • Nair C.R.S.
        • Sarma S.P.
        Frequent seizures and polytherapy can impair quality of life in persons with epilepsy.
        Neurol India. 2005; 53: 46-50
        • Zafar A.
        • Shahid R.
        • Nazish S.
        • Aljaafari D.
        • Alkhamis F.A.
        • Alsalman S.
        • et al.
        Nonadherence to antiepileptic medications: Still a major issue to be addressed in the management of epilepsy.
        J Neurosci Rural Pract. 2019; 10: 106-112
        • Koshy S.
        Role of pharmacists in the management of patients with epilepsy.
        Int J Pharm Pract. 2012; 20: 65-68
      3. Avalere Health LLC. Exploring pharmacists’ role in a changing healthcare environment,; 2014 [accessed 27 February 2020].

        • Goode J.
        • Owen J.
        • Page A.
        • Gatewood S.
        Community-based pharmacy practice innovation and the role of the community-based pharmacist practitioner in the United States.
        Pharmacy (Basel). 2019; 7: 106
        • Bacci J.L.
        • Bigham K.A.
        • Dillon-Sumner L.
        • Ferreri S.
        • Frail C.K.
        • Hamada C.Y.
        • et al.
        Community pharmacist patient care services: a systematic review of approaches used for implementation and evaluation.
        J Am Coll Clin Pharm. 2019; 2: 423-432
      4. Giberson S, Yoder S, Lee MP. Improving patient and health system outcomes through advanced pharmacy practice. A report to the U.S. Surgeon General. Office of the Chief Pharmacist, US Public Health Service,; 2011 [accessed 20 June 2020].

      5. de Barra M, Scott CL, Scott NW, Johnston M, de Bruin M, Nkansah N, et al. Pharmacist services for non‐hospitalised patients. Cochrane Database Syst Rev. 2018;9:CD013102.

      6. National Pharmacist Workforce Study 2019. Final Report,; 2020 [accessed 22 January 2021].

        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Ann Intern Med. 2009; 151: 264-269
        • Clay P.G.
        • Burns A.L.
        • Isetts B.J.
        • Hirsch J.D.
        • Kliethermes M.A.
        • Planas L.G.
        PaCIR: a tool to enhance pharmacist patient care intervention reporting.
        J Am Pharm Assoc. 2019; 59: 615-623
        • Hartlaub P.
        Community pharmacists monitor patients' serum drug levels.
        Am Drug. 1990; 201: 18
        • Kootskias M.E.
        • Hayes G.
        • Thompson J.F.
        • Perlman S.
        • Brinkman J.H.
        Role of a pharmacist in a seizure clinic.
        Am J Hosp Pharm. 1990; 47: 2478-2482
        • McFadyen M.L.
        • Miller R.
        • Juta M.
        • Hodgson V.
        The relevance of a First-World therapeutic drug monitoring service to the treatment of epilepsy in Third-World conditions.
        S Afr Med J. 1990; 78: 587-590
        • Johnson K.A.
        • Nye M.
        • Hill-Besinque K.
        • Cody M.
        Measuring the impact of patient counseling in the outpatient pharmacy setting: Development and implementation of the counseling models for the Kaiser Permanente/USC patient consultation study.
        Clin Ther. 1995; 17: 988-1002
        • Raebel M.A.
        • Chester E.A.
        • Newsom E.E.
        • Lyons E.E.
        • Kelleher J.A.
        • Long C.
        • et al.
        Randomized trial to improve laboratory safety monitoring of ongoing drug therapy in ambulatory patients.
        Pharmacotherapy. 2006; 26: 619-626
        • Swain L.D.
        A pharmacist's contribution to an ambulatory neurology clinic.
        Consult Pharm. 2012; 27: 49-57
        • Martin A.W.
        • Heberle A.P.
        • Knight J.M.
        Interventions associated with implementation of a pharmacist-led neurology pharmacotherapy clinic in an ambulatory care setting.
        J Am Coll Clin Pharm. 2019; 2: 116-122
        • Summers B.
        The effect of a specialist clinic with pharmacist involvement on the management of epilepsy in paediatric patients.
        J Clin Hosp Pharm. 1986; 11: 207-214
        • Chen C.
        • Lee D.S.
        • Hie S.L.
        The impact of pharmacist's counseling on pediatric patients' caregiver's knowledge on epilepsy and its treatment in a tertiary hospital.
        Int J Clin Pharm. 2013; 35: 829-834
        • Eshiet U.
        • Okonta J.
        • Ukwe C.
        The efficacy of a pharmacist implemented educational treatment programme for people with epilepsy: a report of a randomised controlled trial.
        Seizure. 2019; 69: 147-153
        • Ma M.
        • Peng Q.
        • Gu X.
        • Hu Y.
        • Sun S.
        • Sheng Y.
        • et al.
        Pharmacist impact on adherence of valproic acid therapy in pediatric patients with epilepsy using active education techniques.
        Epilepsy Behav. 2019; 98: 14-18
        • McAuley J.W.
        • Mott D.A.
        • Schommer J.C.
        • Moore J.L.
        • Reeves A.L.
        Assessing the needs of pharmacists and physicians in caring for patients with epilepsy.
        J Am Pharm Assoc. 1999; 39: 499-504
      7. Joint Commission of Pharmacy Practitioners. The Pharmacists’ Patient Care Process,; 2021 [accessed 15 January 2021].

      8. CMM in Primary Care Research Team. The Patient Care Process for Delivering Comprehensive Medication Management,; 2018 [accessed 15 January 2021].

        • Patsalos P.N.
        • Berry D.J.
        • Bourgeois B.
        • Cloyd J.B.
        • Glauser T.
        • Johannessen S.I.
        • et al.
        Antiepileptic dugs – best practice guidelines for therapeutic monitoring: a position paper by the subcommission on therapeutic drug monitoring. ILAE Commission on Therapeutic Strategies.
        Epilepsia. 2018; 49: 1239-1276
        • Shinde S.
        • Crawford S.Y.
        The science of safety – an emerging concept in medication use and research.
        Innov Pharm. 2016; 3: 2
        • Johnson C.M.
        • Marcy T.R.
        • Harrison D.L.
        • Young R.E.
        • Stevens E.L.
        • Shadid J.
        Medication reconciliation in a community pharmacy setting.
        J Am Pharm Assoc. 2010; 50: 523-526
        • Odegard P.S.
        • Christensen D.B.
        MAP study: RCT of a medication adherence program for patients with type 2 diabetes.
        J Am Pharm Assoc. 2012; 52: 753-762
        • Sarangarm P.
        • London M.S.
        • Snowden S.S.
        • Dilworth T.J.
        • Koselke L.R.
        • Sanchez C.O.
        • et al.
        Impact of pharmacist discharge medication therapy counseling and disease state education: Pharmacist Assisting at Routine Medical Discharge (project PhARMD).
        Am J Med Qual. 2013; 28: 292-300
        • Brennan A.T.
        • Dollear J.T.
        • Hu M.
        • Matlin O.S.
        • Shrank W.H.
        • Choudhry N.K.
        • et al.
        An integrated pharmacy-based program improved medication prescription and adherence rates in diabetes patients.
        Health Aff. 2012; 31: 120-129
        • Svarstad B.L.
        • Kotchen J.M.
        • Shireman T.I.
        • Brown R.L.
        • Crawford S.Y.
        • Mount J.K.
        • et al.
        Improving refill adherence and hypertension control in black patients: Wisconsin TEAM trial.
        J Am Pharm Assoc. 2013; 53: 520-529
        • Bray P.
        • Cummings D.M.
        • Morrissey S.
        • Thompson D.
        • Holbert D.
        • Wilson K.
        • et al.
        Improved outcomes in diabetes care for rural African Americans.
        Ann Fam Med. 2013; 11: 145-150
        • Roth Y.
        • Neufeld M.Y.
        • Blatt I.
        • Guy-Alfandary S.
        • Rasaby S.
        • Ekstein D.
        • et al.
        An evaluation of pharmacist knowledge on treatment with antiepileptic drugs.
        Seizure. 2016; 34: 60-65
        • McAuley J.W.
        • Chen A.Y.
        • Elliott J.O.
        • Shneker B.F.
        An assessment of patient and pharmacist knowledge of and attitudes toward reporting adverse drug events due to formulation switching in patients with epilepsy.
        Epilepsy Behav. 2009; 14: 113-117
        • McAuley J.W.
        • Casey J.
        • Long L.
        An evaluation of pharmacists’ knowledge of women’s issues in epilepsy.
        Epilepsy Behav. 2009; 14: 243-246
        • Shawahna R.
        Which information on women's issues in epilepsy does a community pharmacist need to know? A Delphi consensus study.
        Epilepsy Behav. 2017; 77 (Epub 2017 Nov 8 PMID: 29127865): 79-89