کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6011274 1579844 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Newer antiepileptic drug use and other factors decreasing hospital encounters
ترجمه فارسی عنوان
استفاده جدید از داروهای ضد صرع و دیگر عوامل کاهش درد بیمارستانی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی علوم اعصاب رفتاری
چکیده انگلیسی


- Second-generation antiepileptic drugs reduce frequency of epilepsy-related hospital encounters.
- The observation is not affected by patient age or sex or by geographic region.
- Antiepileptic drug choice has greater impact on patients with more comorbidities.
- Neurologists are more likely to prescribe a second-generation antiepileptic drug.
- Changing medication after a hospitalization delays the next hospital encounter.

A retrospective analysis was conducted in one claims database and was confirmed in a second independent database (covering both commercial and government insurance plans between 11/2009 and 9/2011) for the understanding of factors influencing antiepileptic drug (AED) use and the role of AEDs and other health-care factors in hospital encounters. In both datasets, epilepsy cases were identified by AED use and epilepsy diagnosis coding. Variables analyzed for effect on hospitalization rates were as follows: (1) use of first-generation AEDs or second-generation AEDs, (2) treatment changes, and (3) factors that may affect AED choice. Lower rates of epilepsy-related hospital encounters (encounters with an epilepsy diagnosis code) were associated with use of second-generation AEDs, deliberate treatment changes, and treatment by a neurologist. Epilepsy-related hospital encounters were more frequent for patients not receiving an AED and for those with greater comorbidities. On average, patients taking ≥ 1 first-generation AED experienced epilepsy-related hospitalizations every 684 days, while those taking ≥ 1 second-generation AED were hospitalized every 1001 days (relative risk reduction of 31%, p < 0.01). Prescriptions for second-generation AEDs were more common among neurologists and among physicians near an epilepsy center. Use of second-generation AEDs, access to specialty care, and deliberate efforts to change medications following epilepsy-related hospital encounters improved outcomes of epilepsy treatment based on average time between epilepsy-related hospital encounters. These factors may be enhanced by public health policies, private insurance reimbursement policies, and education of patients and physicians.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Epilepsy & Behavior - Volume 45, April 2015, Pages 169-175
نویسندگان
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