Epidemiological study of epilepsy by monitoring prescriptions of antiepileptic drugs

Banfi, Roberto; Borselli, Giovanna; Marinai, Claudio; Borgheresi, Alessandra; Cavalieri, A.

doi:10.1007/bf01872391

Cited by 12 publications

(11 citation statements)

References 5 publications

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“…Our data on AED prescribing patterns are confirmed by previous studies conducted in US and in Europe [7,10,11,13,14,20]. The incremental pattern of prescription of gabapentin is in agreement with a recent pharmaco‐economic analysis carried out in the years 1994–2000 in the US [21].…”

Section: Discussionsupporting

confidence: 91%

Prescribing patterns of antiepileptic drugs in Italy: a nationwide population‐based study in the years 2000–2005

Savica

Beghi

Mazzaglia

et al. 2007

Euro J of Neurology

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To evaluate prevalence of use and prescribing patterns of antiepileptic drugs (AEDs) in Italian general practice. Primary care data were obtained from the Health Search Database, a longitudinal observational database implemented by the Italian College of General Practitioners (GPs). We selected 465 061 subjects registered by the end of 2005 in the lists of 320 GPs, homogeneously distributed throughout Italy. Prevalence of AED use was assessed in the entire sample and by drug type, age group, year and main geographic area (north, centre and south/islands). Overall, 24 383 subjects (5.2%) received at least one AED prescription in the study period. Prevalence of AED use (with 95% confidence interval) increased progressively from 7.1 (6.9-7.3) in 2000 to 11.8 (11.5-12.1) in 2005 for old AEDs and from 1.1 (1.0-1.2) to 12.2 (11.9-12.5) for new AEDs. Carbamazepine, phenobarbital and valproic acid were the most common AEDs until 2003, when gabapentin became first. There were no differences in prescribing patterns in the three main geographic areas. Newer AEDs were mostly used in patients aged 65 years and older. The more widespread use of newer AEDs was for mood disorders or pain. Older AED currently remain first line drugs for epileptic disorders. An increasing use of AEDs has been recently observed over a 6-year period in Italian general practice, mostly explained by newer compounds used for conditions other than epilepsy.

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Section: Discussionsupporting

confidence: 91%

Prescribing patterns of antiepileptic drugs in Italy: a nationwide population‐based study in the years 2000–2005

Savica

Beghi

Mazzaglia

et al. 2007

Euro J of Neurology

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“…The increase of AED use during the years 2004–06 is in line with several European drug utilization studies that explored the trend of AED prescriptions [3, 4, 22, 29, 30]. In particular, a recent survey, performed in an Italian general population during 2000–05, showed a prevalence ranging from 11.4 to 34.8 in patients over 65 years [4].…”

Section: Discussionsupporting

confidence: 73%

Prescribing pattern of anti‐epileptic drugs in an Italian setting of elderly outpatients: a population‐based study during 2004–07

Oteri

Trifirò

Gagliostro

et al. 2010

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• In the last years there has been a growing trend in anti-epileptic drug (AED) use, particularly in elderly patients, but few data concerning indication of use are available in general practice.• Various AEDs, including newer agents, have been approved for indications other than epilepsy and are increasingly also used for unlicensed indications.• No data about the impact of re-imbursement restrictions on the choice of anti-epileptic drugs in general practice are available. WHAT THIS STUDY ADDS• In general practice, a rapid increase of AED prescriptions in the elderly was observed, principally due to the use of newer AEDs for indications other than epilepsy.• Re-imbursement restrictions influenced newer AED use, particularly pregabalin and gabapentin prescriptions.• Phenobarbital, accounting for more than 50% of total AED volume, was the most prescribed medication during the entire study period. This finding should be considered in light of the potential risks associated with phenobarbital use in the geriatric population. AIMSThe aims of the study were to assess the trend of older and newer anti-epileptic drugs (AEDs) in the elderly population and to analyze the effects of a health-policy intervention with regard to AED use in general practice in a setting in Southern Italy. METHODSData were extracted from the 'Caserta-1' Local-Health-Unit Arianna database in the years 2004-07. Patients aged over 65 years, receiving at least one AED prescription and registered in the lists of 88 general practitioners, were selected. The use of older and newer AEDs was calculated as 1 year prevalence and incidence of use and defined daily dose (DDD) per 1000 inhabitants day -1. Sub-analyses by gender, age and indication of use were performed. RESULTSMost of AED users were treated because of neuropathic pain (64.8%). However, the main indication of use for older AEDs (57.8%) was epilepsy, whereas newer AEDs (79.5%) were used for neuropathic pain. Prevalence and incidence of newer AED use increased until 2006, followed by a reduction in 2007. Newer AEDs, particularly gabapentin and pregabalin, were used in the treatment of more patients than older AEDs. However phenobarbital, accounting for more than 50% of total AED volume, was the most prescribed medication during the entire study period. CONCLUSIONSAn increasing use of AEDs has been observed during 2004-07, mostly due to the prescription of newer compounds for neuropathic pain. The fall in the use of newer AEDs during 2007 coincides with revised re-imbursement criteria for gabapentin and pregabalin. The large use of phenobarbital in the elderly should be considered in the light of a risk of adverse drug reactions.

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“…Several other researchers have also studied antiepileptic drug utilisation [8][9][10][11][12][13] . Our study has the same two limitations as some of the others.…”

Section: Discussionmentioning

confidence: 99%

“…Shackleton et al demonstrated that for almost 50% of the patients on carbamazepine monotherapy, the indication was not epilepsy 11 . In several of the epidemiological studies, corrections were made for off-label use by applying a cor-rection factor of 0.68 8,14 . For new AEDs, the correction factor is not yet known, but it is likely that there is offlabel use of these compounds as well.…”

Section: Discussionmentioning

confidence: 99%

Volume and market share of anti-epileptic drugs in the Netherlands: impact of new drugs

Knoester

Deckers

Vaart³

et al. 2005

Pharm World Sci

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Epidemiological study of epilepsy by monitoring prescriptions of antiepileptic drugs

Cited by 12 publications

References 5 publications

Prescribing patterns of antiepileptic drugs in Italy: a nationwide population‐based study in the years 2000–2005

Prescribing patterns of antiepileptic drugs in Italy: a nationwide population‐based study in the years 2000–2005

Prescribing pattern of anti‐epileptic drugs in an Italian setting of elderly outpatients: a population‐based study during 2004–07

Volume and market share of anti-epileptic drugs in the Netherlands: impact of new drugs

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