Evidence map›Paper›PMID 39825782›Full record

SynthesisEpilepsia2025

Association of social determinants of health with first antiseizure medication prescription for patients with newly diagnosed epilepsy: A systematic review and meta-analysis.

Brian J Johnson, Katie E Jung, Megan A MacKenzie, Abdulsalam Bah, Nathalie Jetté, Nihal Mohamed, Leah J Blank

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Brian J JohnsonIcahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID https://orcid.org/0009-0006-1191-6227
Katie E JungDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Megan A MacKenzieDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abdulsalam BahIcahn School of Medicine at Mount Sinai, New York, New York, USA.
Nathalie JettéDepartment of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0003-1351-5866
Nihal MohamedDepartment of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Leah J BlankDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID https://orcid.org/0000-0001-8719-6752

Funding

Research Training for the Care of Vulnerable Older Adults with Alzheimer’s Disease and Related Dementias and Other Chronic ConditionsT32AG066598 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Alex D Federman · 2020 to 2026
$2.3M
Seizure, cognitive change and dementia: Understanding the use and safety of anti-seizure medicationsK23AG080163 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Leah Blank · 2023 to 2026
$664k
NIA NIH HHS 5P30AG028741NIA NIH HHS K23 AG080163NIA NIH HHS T32 AG066598
6 · The paper itself

Abstract

objectiveTo assess whether social determinants of health (SDOHs) are associated with the first antiseizure medication (ASM) prescribed for newly diagnosed epilepsy.

methodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed, and the protocol registered (CRD42023448998). Embase, Medline, and Web of Science were searched up to July 31, 2023. Two reviewers independently screened studies and reached mutual consensus for inclusion. Studies reporting the first ASM prescribed for patients with new epilepsy in all age groups, countries, and languages were eligible for inclusion. Review articles, conference abstracts, and studies with fewer than 15 participants were not eligible for inclusion. Studies were meta-analyzed using fixed-effects models. Quality assessment was performed using the Newcastle-Ottawa Scale.

resultsThirteen studies (total participants = 380,785) contained SDOH data and their association with the first ASM prescription after epilepsy diagnosis. Meta-analysis of studies with compatible data revealed that Black (pooled odds ratio [OR] .94, 95% confidence interval [CI] .90-.98) and Hispanic (pooled OR .89, 95% CI .82-.97) patients with U.S. Medicare/Medicaid had a lower odds of receiving a newer ASM compared to White patients. Three studies revealed that rural epilepsy patients had a lower odds of receiving new ASMs compared to urban patients (pooled OR .84, 95% CI .80-.89). The relationship between income levels and ASM prescription patterns differed across countries, highlighting inconsistencies that warrant further investigation. Among studies identified for inclusion, relatively few had combinable data, thereby limiting the scope of our meta-analysis to two SDOHs. SIGNIFICANCE: Significant disparities exist in first-line ASM prescription for non-White and rural persons with epilepsy. There exist few data on other SDOHs including gender identity and socioeconomic background. Future work leveraging large data sets may reveal additional ASM prescription inequities. Developing care pathways to rectify known prescribing disparities may improve health equity among PWE.

Indexed as

AnticonvulsantsEpilepsySocial Determinants of HealthHumansAnticonvulsantsantiepileptic drugASMhealth disparitieshealth equityseizure

Identifiers

PMID39825782
PMCPMC13098492

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.