Analysis relationship of self-medication card administration with adherence (ARMS score), phenytoin serum levels and frequency of seizures in patients using phenytoin monotherapy

Aim and Objective: The purpose of this study was to analyze of administration self-medication card on adherence, phenytoin levels, and frequency of seizure of patients taking phenytoin monotheraphy neurology outpatients unit of Dr. Soetomo Hospital, Surabaya. Methods: This study was a prospective study using 18 samples using monotheraphy of phenytoin. This study measured patient adherence using direct and indirect methods. The direct method was used to determine the level of phenytoin in the blood using ELISA (Enzyme Linked Absorbent Assay). The indirect method used was interviews using the ARMS questionnaire. Patients who became the subject of this study used generic of phenytoin (sodium phenytoin) given 3 x 100mg/day. Result and conclusion: Analysis of relationships in this study used categorical data. The relationship between administration of self-medication in outpatients using phenytoin monotherapy to the level of adherence (using the ARMS questionnaire) was significant difference statistically with p= 0.02 (p<0.05). Whereas the relationship between giving a card with minimal self-medication to phenytoin levels (p= 0.102) and the frequency of seizures (p= 0.180) was not significant difference statistically. This occurs because the level of phenytoin was strongly influenced by many factors including phenytoin pharmacokinetics, patient's condition, the presence or absence of drug interactions and phenytoin polymorphisms that are individual factor in each patient. The appearance of seizure frequency was not only influenced by medication adherence but also several other factors such as the etiology, location, type of seizure, the presence or absence of trigger seizures.