ArticleMedical care2017
Quality of Antiepileptic Treatment Among Older Medicare Beneficiaries With Epilepsy: A Retrospective Claims Data Analysis.
Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Pooled it
- Disparities in Epilepsy Diagnosis and Management in High-Income Countries: A Review of the Literature.Neurology. Clinical practice · 2024Review
- Racial and Ethnic Differences in Antiseizure Medications Among People With Epilepsy on Medicaid: A Case of Potential Inequities.Neurology. Clinical practice · 2023Article
- Treatment gaps in epilepsy.Frontiers in epidemiology · 2022Review
- Utilization of epilepsy surgery in the United States: A study of the National Inpatient Sample investigating the roles of race, socioeconomic status, and insurance.Surgical neurology international · 2021Article
- Trends in oral anticoagulant co-prescription with antiepileptic drugs among adults with epilepsy, 2010-2018.Epilepsy & behavior : E&B · 2020Article
- Developing and Validating a Measure to Estimate Poverty in Medicare Administrative Data.Medical care · 2019Article
- High health care costs in minority groups of older US Medicare beneficiaries with epilepsy.Epilepsia · 2019Article
- Risk of pharmacokinetic interactions between antiepileptic and other drugs in older persons and factors associated with risk.Epilepsia · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundEnzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. RESEARCH
designRetrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation. Logistic regressions examined QUIET-9 concordance differences by race/ethnicity adjusting for individual, socioeconomic, and geography factors. SUBJECTS: Epilepsy prevalent (≥1 International Classification of Disease-version 9 code 345.x or ≥2 International Classification of Disease-version 9 code 780.3x, ≥1 AED), and new (same as prevalent+no seizure/epilepsy events nor AEDs in 365 d before index event) cases. MEASURES: Use of EI-AEDs and QUIET-9 concordance (no EI-AEDs for the first 2 AEDs).
resultsCases were 21% white, 58% African American, 12% Hispanic, 6% Asian, 2% American Indian/Alaskan Native. About 65% of prevalent, 43.6% of new cases, used EI-AEDs. QUIET-9 concordance was found for 71% Asian, 65% white, 61% Hispanic, 57% African American, 55% American Indian/Alaskan new cases: racial/ethnic differences were not significant in adjusted model. Beneficiaries without neurology care, in deductible drug benefit phase, or in high poverty areas were less likely to have QUIET-9 concordant care.
conclusionsEI-AED use is high, and concordance with recommendations low, among all racial/ethnic groups of older adults with epilepsy. Potential socioeconomic disparities and drug coverage plans may affect treatment quality and opportunities to live well with epilepsy.
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Registered trials
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