An Evaluation of Antiepileptic Drug Therapy In Nursing Facilities

Schachter, Steven C.; Cramer, Gena W.; Thompson, G. G.; Chaponis, RJ; Mendelson, Marilyn A.; Lawhorne, Larry Wayne

doi:10.1111/j.1532-5415.1998.tb06654.x

Cited by 76 publications

(44 citation statements)

References 15 publications

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“…These findings were explained by the high prevalence of environmental risk factors like traumatic brain injury and alcoholism in this population. Even in nursing home residents, a high-risk population, the prevalence of epilepsy can exceed 5% [19].…”

Section: Prevalence Of Seizures and Epilepsy In The Elderlymentioning

confidence: 99%

Aging and the Epidemiology of Epilepsy

Beghi

Giussani²

2018

Neuroepidemiology

141

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Background: Epilepsy is a chronic disorder affecting all ages but with a peak in the elderly. The association of epilepsy with age can be explained by the predominance of brain diseases with epileptogenic potential (mostly stroke and dementia) and by the effects of the aging process through a number of molecular mechanisms involving networks of neurons with focal or diffuse distribution. Summary: The prevalence of active epilepsy is 6.4 per 1,000 and the lifetime prevalence is 7.6 per 1,000. The prevalence tends to increase with age, with peaks in the oldest age groups and in socially deprived individuals. The incidence of epilepsy is 61.4 per 100,000 person-years. Epilepsy has a bimodal distribution according to age with peaks in the youngest individuals and in the elderly. The increased incidence of seizures and epilepsy in the elderly can be attributed to the increase of age-related and aging-related epileptogenic conditions. Key Messages: As the world population is steadily growing with parallel increase in the number of aged subjects, in the future, epilepsy will represent a huge burden for the society. Measures must thus be taken to prevent seizures and epilepsy through the reduction of preventable epileptogenic factors.

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Section: Prevalence Of Seizures and Epilepsy In The Elderlymentioning

confidence: 99%

Aging and the Epidemiology of Epilepsy

Beghi

Giussani²

2018

Neuroepidemiology

141

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“…To withdraw AED patient has to be seizure free for 3-4 years since sudden withdraw increases seizure frequency and severity. 11,[15][16][17][18][19][20] Though different studies have been conducted in different parts of the world including Africa, to our knowledge analysis of treatment outcome among epileptic patients in the general hospitals of Ethiopia was not well studied except in particular wards and disease conditions. This is particularly true in the study.…”

Section: Introductionmentioning

confidence: 99%

Anti-epileptic drug utilization and treatment outcome among epileptic patients on follow-up in a resource poor setting

Gurshaw¹,

Agalu²,

Chanie³

2014

J. Young Pharm.

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Introduction: Anti-epileptic drugs (AEDs) are the primary therapeutic modes for epileptic patients and have been demonstrated to control seizure, which decreases morbidity and mortality associated with epilepsy. There is a paucity of data on treatment outcome among epileptic patients in resource poor settings. The aim of this study was to assess AED utilization pattern and treatment outcome among epileptic patients on follow-up. Materials and Methods: A retrospective cross-sectional study was conducted among epileptic patients on follow-up at Epilepsy clinic of Jimma University specialized hospital. A total of 290 patient record cards which had 3 years of follow-up information was used to evaluate AED utilization pattern and treatment outcome through medical records review. Results: From a total 290 cards of epileptic patients on follow-up, 170 (58.6%) were males. The common type of seizure diagnosed was generalized tonic clonic seizure, 232 (80%). Monotherapy was commonly used in the management of seizure, 54.5%, among which phenobarbitone was the most commonly utilized single anticonvulsant drug. One hundred and sixty-five (56.7%) patients were seizure free during follow-up periods and 125 (43.3%) patients were not, of which 121 (73.3%) of patients had 1 up to 5 seizure attacks per 3 months during the 3 years follow-up period. Conclusion: All studied epileptic patients were put on traditional AEDs; phenobarbitone being the most frequently prescribed single drug. About one in every two epileptic patients evaluated were seizure free during the 3 years follow-up period.

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“…Those with dementia have 1.0 times the odds of epi/sz compared to those without dementia. This is largely true by demographic subgroup as well; for example, men and women alike have an OR for epi/sz associated with [17][18][19][20][21] The prevalence of epi/sz in NHs is much greater than observed in communitydwelling persons $65 years of age, which is z1% to 1.5%. 4,22 The 7-to 8-fold increase in the prevalence of epi/sz in NH elderly compared to communitydwelling elderly suggests an increased incidence of epilepsy either before entering the NH or after admission.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes

et al. 2017

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Objective: To determine the prevalence of epilepsy/seizure (epi/sz) comorbid with other neurologic disorders in elderly nursing home residents and to examine demographic and regional variability and associations with clinical characteristics.Methods: We studied 5 cross-sectional cohorts of all residents in any Medicare/Medicaid-certified nursing home in the United States on July 15 of each year from 2003 to 2007. Epi/sz was identified by ICD-9 codes (345.xx or 780.39) or check box (Minimum Data Set). Epi/sz prevalence was stable across all years, so only 2007 data were examined further. Logistic regression with generalized estimating equations was used to model cross-sectional prevalence of epi/sz as a function of demographics and neurologic comorbidities of interest, with adjustment for clinical characteristics, including cognitive status, comorbidity burden, medication burden, and activities of daily living.Results: Point prevalence of epi/sz in 2007 was 7.7% (n 5 91,372 of N 5 1,186,579) differing by geographical region, race/ethnicity, age group, and sex. Neurologic conditions having the highest association with epi/sz were brain tumor (epi/sz prevalence 23.4%-35.2%), head injury (17.9%), hemiplegia (17.7%), and stroke (13.7%). Epi/sz comorbid with stroke or dementia had a strong decreasing association with age (65-74 years had z3.8-times higher odds of epi/sz than 851 years). Activities of daily living, comorbidity burden, and cognition scores were worse in persons with than without epi/sz. Conclusions:The prevalence of epi/sz in the elderly nursing home population is .7-fold higher compared to community-dwelling elderly and is 7 to 30 times higher among those with certain comorbid neurologic conditions. Demographics and clinical characteristics had weaker associations with epi/sz prevalence. Neurology ® 2017;88:750-757 GLOSSARY ASD 5 antiseizure drug; epi/sz 5 epilepsy/seizure; ICD-9 5 International Classification of Diseases, ninth revision; MDS 5 Minimum Data Set; MS 5 multiple sclerosis; NH 5 nursing home; OR 5 odds ratio.Because of their general health, elderly individuals are much more likely to have severe consequences from a seizure than younger persons.1 With increasing concern regarding the ability to provide adequate and appropriate care to the nursing home (NH) population, it is important to define the epidemiology of epilepsy in this cohort. In community-dwelling elderly, the prevalence of epilepsy is z1.1%.2,3 A majority of these cases are located in the geographic Stroke Belt. [4][5][6] Neurologic conditions comorbid with epilepsy are also common in NH elderly. Although the number of elderly will more than double in the United States, approaching 71.5 million by 2030, 7 and the lifetime probability of a person entering an NH before death is 43% to 46%, 8 there has not been a systematic evaluation of the prevalence of epilepsy with other neurologic disorders or the activity or cognitive status of these individuals.We obtained the Minimum Data Set (MDS) assessments completed on all resi...

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An Evaluation of Antiepileptic Drug Therapy In Nursing Facilities

Cited by 76 publications

References 15 publications

Aging and the Epidemiology of Epilepsy

Aging and the Epidemiology of Epilepsy

Anti-epileptic drug utilization and treatment outcome among epileptic patients on follow-up in a resource poor setting

Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes

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