Observational studyCNS drugs2014
Factors associated with seizure recurrence in epilepsy patients treated with antiepileptic monotherapy: A retrospective observational cohort study using US administrative insurance claims.
Observational study in CNS drugs, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- An intensive education program for caregivers ameliorates anxiety, depression, and quality of life in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis who underwent cortico-amygdalohippocampectomy.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2020Trial
- Feature Exploration and Causal Inference on Mortality of Epilepsy Patients Using Insurance Claims Data.... IEEE-EMBS International Conference on Biomedical and Health Informatics. IEEE-EMBS International Conference on Biomedical and Health Informatics · 2019Article
- Demographic and Clinical Correlates of Seizure Frequency: Findings from the Managing Epilepsy Well Network Database.Journal of clinical neurology (Seoul, Korea) · 2018Article
- Stimulants Do Not Increase the Risk of Seizure-Related Hospitalizations in Children with Epilepsy.Journal of child and adolescent psychopharmacology · 2018Article
- Comparison of Drug Utilization Patterns in Observational Data: Antiepileptic Drugs in Pediatric Patients.Paediatric drugs · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFew studies examine predictors of seizures in medically treated patients with epilepsy receiving antiepileptic monotherapy using a large patient population.
objectiveOur objective was to identify clinical, medication, and demographic factors associated with seizure recurrence in medically treated patients with epilepsy receiving one of four antiepileptic monotherapy regimens: lamotrigine, levetiracetam, oxcarbazepine, or topiramate. STUDY
designA retrospective cohort study was conducted using Innovus Invision™ Data Mart paid medical and prescription US commercial insurance claims data from January 2007 to September 2010.
methodsPatients aged 18-64 years with a primary or secondary diagnosis of epilepsy and one or more prescription claim for an antiepileptic drug (AED) pre-index were included. The primary outcome was incidence of a seizure or seizure-related event, defined as an emergency room visit, ambulance service use, or inpatient hospitalization medical claim with a primary or secondary diagnosis of epilepsy during the 1-year follow-up. The factors included AED adherence, somatic comorbidity (measured via Charlson Comorbidity Index), mental health comorbidity, pre-index seizure, type of epilepsy diagnosis, presence of AED-interacting medications and any bioequivalent AED switch. The covariates included age, gender, and geographic region of residence.
resultsA total of 5.3 % (166/3,140) of patients on AED monotherapy had experienced a seizure or a seizure-related event requiring urgent care at 1-year follow-up. The multivariate analysis of the combined cohort showed that pre-index seizures/seizure-related events (odds ratio [OR] 4.23; 95 % confidence interval [CI] 2.77-6.46), any mental health comorbidity (OR 3.50; 95 % CI 2.14-5.70), and Charlson Comorbidity Index ≥1 (OR 2.91; 95 % CI 1.98-4.28) were significantly associated with post-index seizures/seizure-related events. Patients residing in Northeastern USA had a higher likelihood of a post-index seizure (OR 1.90; 95 % CI 1.17-3.08) than patients residing in the Southern region of the USA. Bioequivalent AED switch, type of epilepsy diagnosis, AED adherence, and presence of AED-interacting medications were not associated with seizure recurrence in the combined cohort analysis (p > 0.05).
conclusionsEpilepsy patients with comorbid conditions (both mental and somatic diseases) and prior seizures were more likely to experience seizures at 1-year follow-up. Non-adherent patients and patients with bioequivalent AED switches appeared to show no increased likelihood of seizure at follow-up. Clinicians may consider these findings before starting or transitioning to an AED monotherapy.
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