Trends, prescribing patterns, and determinants of initial antiepileptic drug treatment in older epileptic patients.

IF 1.5 Q3 PHARMACOLOGY & PHARMACY
Noppaket Singkham, Pitsamai Saiwijit, Papavee Sangliamthong, Tawanrat Panthong, Hataikan Wiangkham
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引用次数: 0

Abstract

Objectives: There is no report on the initial antiepileptic drug (AED) treatment of older Thai epileptic patients. This study aimed to determine the trends, prescribing patterns, and determinants of initial AED treatment.

Methods: This cross-sectional study used data on older (≥60 years) epileptic patients gathered from one tertiary-care hospital's database from 2012 to 2022. We evaluated the trends and prescribing patterns for starting AED treatment. We used logistic regression to identify the determinants of the initial treatment with new-generation AEDs.

Key findings: This study comprised 919 participants (59.19% men, 70.99 ± 8.00 years old). Between 2012 and 2022, we observed a decreasing trend in starting therapy with old-generation AEDs, from 89.16% to 64.58%. In contrast, there was an increasing trend in initiating treatment with new-generation AEDs, from 10.84% to 35.72% (P for trend <0.001 for both). Each assessment year, the most prescribed treatment pattern was monotherapy. The determinants of initial therapy with new-generation AEDs included the year treatment began (adjusted odds ratios [AOR] = 1.0006; 95% confidence intervals [CI] 1.0003-1.0008), non-Universal Coverage Scheme (AOR = 1.94; 95% CI 1.26-3.00), liver disease (AOR = 6.44; 95% CI 2.30-18.08), opioid use (AOR = 2.79; 95% CI 1.28-6.09), and statin use (AOR = 0.59; 95% CI 0.36-0.95).

Conclusions: There is a growing trend of initiating treatment with new-generation AEDs in older Thai patients with epilepsy. Factors positively associated with starting new-generation AEDs include the year treatment began, non-Universal Coverage Scheme, liver disease, and opioid use, while statin use is a negatively associated factor.

老年癫痫患者初始抗癫痫药物治疗的趋势、处方模式和决定因素。
目的:目前还没有关于泰国老年癫痫患者初始抗癫痫药物(AED)治疗的报告。本研究旨在确定初始 AED 治疗的趋势、处方模式和决定因素:这项横断面研究使用了一家三级甲等医院数据库中 2012 年至 2022 年老年(≥60 岁)癫痫患者的数据。我们评估了开始 AED 治疗的趋势和处方模式。我们使用逻辑回归来确定新一代 AEDs 初始治疗的决定因素:这项研究包括 919 名参与者(59.19% 为男性,70.99 ± 8.00 岁)。2012年至2022年期间,我们观察到使用老一代AEDs开始治疗的比例呈下降趋势,从89.16%降至64.58%。相比之下,开始使用新一代 AEDs 治疗的比例呈上升趋势,从 10.84% 上升至 35.72%(P 为趋势结论):泰国老年癫痫患者开始使用新一代 AEDs 治疗的比例呈上升趋势。与开始新一代 AEDs 治疗呈正相关的因素包括开始治疗的年份、非全民医保计划、肝病和阿片类药物的使用,而他汀类药物的使用则是一个负相关因素。
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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