Impact of epilepsy on employment in Malaysia

Lim, Kheng‐Seang; Wo, Su Woan; Wong, Mee Hoo; Tan, Chong Tin

doi:10.1016/j.yebeh.2012.12.034

Cited by 26 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The modelled population consisted of a hypothetical cohort of newly diagnosed Malaysian adults with epilepsy, aged 19 years (considering the average age of epilepsy onset in Malaysian adults is 19 years), in whom CBZ was considered suitable as first‐line monotherapy …”

Section: Methodsmentioning

confidence: 99%

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

et al. 2017

View full text Add to dashboard Cite

Background Strong association was documented between human leukocyte antigen (HLA)-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Beyond Asia, the HLA testing is potentially valuable in many countries with increasingly diverse communities of Asian ancestry, to facilitate an early recognition of patient susceptibility to SCARs. Objective To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/ toxic epidermal necrolysis in an ethnically-diverse Malaysian population. Methods A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly-diagnosed epilepsy among adults - (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. From a societal perspective, base-case analysis and sensitivity analyses were performed over lifetime time horizon. Incremental cost-effectiveness ratios were calculated. Results In the base-case analysis, both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared to current practice, universal HLA-B*15:02 screening resulted in 0.0255 quality-adjusted life years (QALYs) loss at an additional cost of USD707, while VPA prescribing resulted in 0.2622 QALYs loss at an additional cost of USD4,127, due to estimated differences in antiepileptic treatment efficacy. Conclusions This study suggests that universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia compared to current practice. However, with the emergence of an ethnically-diverse population in many other countries, this may render HLA-B*15:02 screening a potentially viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.

show abstract

Section: Methodsmentioning

confidence: 99%

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In a Malaysian study to ascertain the impact of epilepsy on employment among 250 patients with epilepsy from a neurology clinic, 20% were unemployed and 10.4% were employed part‐time despite a robust economy and low social security . Compared with their siblings, patients with epilepsy were more likely to be unemployed, to be single, to have lower education level, and to have lower monthly income.…”

Section: Psychosocial Diagnostic and Treatment Challengesmentioning

confidence: 99%

Epilepsy in Asia: Disease burden, management barriers, and challenges

et al. 2018

View full text Add to dashboard Cite

This article reviews the burden of epilepsy in Asia, the challenges faced by people with epilepsy, and the management of epilepsy. Comparison is made with other parts of the world. For this narrative review, data were collected using specified search criteria. Articles investigating the epidemiology of epilepsy, diagnosis, comorbidities and associated mortality, stigmatization, and treatment were included. Epilepsy is a global health care issue affecting up to 70 million people worldwide. Nearly 80% of people with epilepsy live in low- and middle-income countries with limited resources. People with epilepsy are prone to physical and psychological comorbidities, including anxiety and depression, which can negatively impact their quality of life. Furthermore, people with epilepsy are at higher risk of premature death than people without epilepsy. Discrimination or stigmatization of people with epilepsy is common in Asia and can affect their education, work, and marriage opportunities. Access to epilepsy treatment varies throughout Asia. Although highly advanced treatment is available in some countries, up to 90% of people with epilepsy are not adequately treated or are not treated with conventional antiepileptic therapy in resource-limited countries. People in remote areas often do not receive any epilepsy care. First-generation antiepileptic drugs (AEDs) are available, but usually only in urban areas, and second-generation AEDs are not available in all countries. Newer AEDs tend to have more favorable safety profiles than first-generation AEDs and provide options to tailor therapy for individual patients, especially those with comorbidities. Active epilepsy surgery centers are present in some countries, although epilepsy surgery is often underutilized given the number of patients who could benefit. Further epidemiologic research is needed to provide accurate epilepsy data across the Asian region. Coordinated action is warranted to improve access to treatment and care.

show abstract

“…Gender (Bishop, 2004;Gopinath et al, 2011;Jacoby, 1995;Komolafe et al, 2012;Lim et al, 2013a;Lim et al, 2013b;Sillanpaa and Schmidt, 2010;Varma et al, 2007) Gender (Al-Saad et al, 2001;Bautista and Wludyka, 2007;Chaplin, 1992;Elwes et al, 1991;George et al, 2009;Haag et al, 2010;Majkowska-Zwolinska et al, 2012) Seizure control (Al-Saad et al, 2001;Baker et al, 1997;Benifla et al, 2008;Callaghan et al, 1992;Chin et al, 2007;De Boer, 2005;Elwes et al, 1991;Geerts et al, 2011;Herodes et al, 2001;Holland et al, 2009;Jacoby et al, 2005;Koponen et al, 2007;Lazow et al, 2012;Lee, 2005;Lim et al, 2013c;Maganti et al, 2003;Majkowska-Zwolinska et al, 2012;Rätsepp et al, 2000;Scambler and Hopkins, 1980;Schwartz et al, 1968) (Reeves et al, 1997;Sillanpaa et al, 2004;…”

Section: Socio-demographic Factors (N = 42 Papers)mentioning

confidence: 99%

“…of sick leaves (Lassouw et al, 1997) Vocational training (Lassouw et al, 1997) Injury frequency during seizure attack (Dennerll et al, 1966) Others: Seizure diagnosis (Herodes et al, 2001;Sillanpaa et al, 1998;Wheless, 2006) Seizure severity (De Boer, 2005;Lim et al, 2013c) Epilepsy Type (Lim et al, 2013c;Pal et al, 2008) Age of surgery epilepsy (George et al, 2009;Zarroli et al, 2011) Having partial seizure history (Jacoby et al, 2005) Seizure epilepticus (Sillanpaa and Schmidt, 2010) Responsiveness to AED (Lim et al, 2013c) Side effect of AED (Wheless, 2006) Medicine compliance (Chen et al, 2010) Approval of LEV (Korchounov et al, 2012) History of psychotic test (Wada et al, 2001) Post ATL follow-up duration (George et al, 2009) Others: Types of antiepileptic drug (Haag et al, 2010) Use of antiepileptic drugs (Jacoby et al, 2005) History of Convulsion (Bautista and Wludyka, 2007) History of GTC in last year (Lee, 2005) Side effect of AED (Bautista and Wludyka, 2007) Side of lesion (Bautista and Wludyka, 2007;Zarroli et al, 2011) Timing of seizure attack (Elwes et al, 1991;Lee, 2005;The RESt-1 Group, 2000) Others:…”

Section: Socio-demographic Factors (N = 42 Papers)mentioning

confidence: 99%

Employability in people with epilepsy: A systematic review

Lim

Choo

et al. 2015

Epilepsy Research

Self Cite

View full text Add to dashboard Cite

Impact of epilepsy on employment in Malaysia

Cited by 26 publications

References 21 publications

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

Epilepsy in Asia: Disease burden, management barriers, and challenges

Employability in people with epilepsy: A systematic review

Contact Info

Product

Resources

About

Impact of epilepsy on employment in Malaysia

Cited by 26 publications

References 21 publications

Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

Epilepsy in Asia: Disease burden, management barriers, and challenges

Employability in people with epilepsy: A systematic review

Contact Info

Product

Resources

About

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia

Is universal HLA-B15:02* screening a cost-effective option in an ethnically diverse population? A case study of Malaysia