Sociodemographic differences in antiepileptic drug prescriptions to adult epilepsy patients

Mattsson, Peter; Tomson, Torbjörn; Eriksson, Olle; Brännström, Lars; Weitoft, Gunilla Ringbäck

doi:10.1212/wnl.0b013e3181cbcd5c

Cited by 43 publications

(55 citation statements)

References 21 publications

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“…The most obvious one could be socioeconomic differences which are not reflected in the type of insurance. There are definite disparities in the relative use of first-generation AEDs versus second-generation AEDs prescribed to some socioeconomic and racial groups [12,13]. Another explanation for the apparently greater benefit of newer drugs might be greater comorbidity or more serious etiologies of epilepsy among the patients receiving older drugs, but we controlled for comorbidity by using the Charlson Comorbidity Index.…”

Section: Discussionmentioning

confidence: 99%

Newer antiepileptic drug use and other factors decreasing hospital encounters

Faught

Helmers

Begley

et al. 2015

Epilepsy & Behavior

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Section: Discussionmentioning

confidence: 99%

Newer antiepileptic drug use and other factors decreasing hospital encounters

Faught

Helmers

Begley

et al. 2015

Epilepsy & Behavior

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“…Pricing may also be an issue, and the prescribing trends suggest that those patients traditionally less likely to be able to afford brand name are less likely to receive one. A 2010 study by Mattsson et al found that certain sociodemographic factors of patients with epilepsy were linked to access to a specialist—these factors included being young and having a higher income [22]. This suggests that patients with epilepsy who are elderly and have lower incomes are less likely to have access to a specialist and, possibly, brand name AEDs.…”

Section: Discussionmentioning

confidence: 99%

Generic antiepileptic drug prescribing: A cross-sectional study

Meyer

Fardo

Fleming

et al. 2013

Epilepsy & Behavior

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The use of generic antiepileptic drugs (AEDs) in patients with epilepsy is controversial. The purpose of this study is to identify patient characteristics associated with increased odds of receiving a generic AED product. A large commercial database was used to identify patients with a primary diagnosis of epilepsy who were prescribed an AED during a three-month window. Data analysis found that those ≥65 years old had 15.7% greater odds of receiving a generic AED (OR = 1.157; 95% CI = 1.056–1.268). Patients with Medicaid were found to have 2.44 times the odds of having had a generic AED prescription (OR = 2.44; CI = 2.168–2.754). Patients residing in the Northeast had 12.6% decreased odds of receiving a generic AED (OR = 0.874; CI = 0.821–0.931). These patient characteristics could signify certain health care disparities and may represent potential confounders to future observational studies.

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“…For the purpose of this study, patients with occurrence of any of ICD-10-codes G40, G41, or R56.8 more than 7 days after the stroke index date were classified as PSE. The positive predictive value of the epilepsy diagnosis in the NPR is not known, but the register is frequently used to identify epilepsy in register-based research [13, 14]. Causes of death in Sweden are reported in text on a death certificate by a physician and coded as International Classification of Disease (ICD)-10 codes by the National Board of Health and Welfare according to the instruction in the ICD-10 manual.…”

Section: Methodsmentioning

confidence: 99%

Cause of death in patients with poststroke epilepsy: Results from a nationwide cohort study

et al. 2017

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The risk of death is increased for persons with epilepsy. The literature on causes of death in epilepsy is based mainly on cohorts with epilepsy of mixed aetiologies. For clinical purposes and improved understanding of mortality in different epilepsies, more information is needed on mortality in epilepsies of specific causes. In poststroke epilepsy (PSE), seizures occur in a setting of vascular disease and high mortality rates. The extent to which epilepsy contributes to mortality in this patient group is poorly understood. We therefore aimed to describe causes of death (COD) in PSE on a national scale. A previously identified cohort of 7740 patients with epilepsy or seizures after a stroke in 2005–2010 was investigated. A total of 4167 deaths occurred before the end of 2014. The standardized mortality ratio for the study cohort was 3.56 (95% CI: 3.45–3.67). The main underlying causes of death were disorders of the circulatory system (60%) followed by neoplasms (12%). Diseases of the nervous system were the sixth leading underlying COD (3%), and epilepsy or status epilepticus was considered the underlying COD in approximately a similar proportion of cases as neurodegenerative disorders (0.9% and 1.1%, respectively). Epilepsy was considered a contributing COD in 14% of cases. Our findings highlight the importance of optimal management of vascular morbidity in patients with PSE. The large proportion of patients with epilepsy as a contributing COD indicate the need of high ambitions also regarding the management of seizures in patients with PSE.

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Sociodemographic differences in antiepileptic drug prescriptions to adult epilepsy patients

Cited by 43 publications

References 21 publications

Newer antiepileptic drug use and other factors decreasing hospital encounters

Newer antiepileptic drug use and other factors decreasing hospital encounters

Generic antiepileptic drug prescribing: A cross-sectional study

Cause of death in patients with poststroke epilepsy: Results from a nationwide cohort study

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