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PHILADELPHIA – Roughly half of U.S. patients newly diagnosed with epilepsy fail to receive a stable and effective treatment that keeps them seizure free during the first year following their diagnosis, according to an analysis of more than 17,000 incident epilepsy cases who received documented treatment with antiepileptic drugs and had at least 1 year of follow-up.
“Under the best health care circumstances, we can achieve full seizure control in two-thirds to 70% of patients, but the fact that we fall way short points to a treatment gap,” said Dr. David J. Thurman, a neurologist and epilepsy specialist who practices in Atlanta and is affiliated with Emory University. “We’re doing a lousy job,” he said in an interview while presenting a poster at the annual meeting of the American Epilepsy Society.
Dr. Thurman suggested that several factors likely contribute to epilepsy patients receiving less than ideal care, including their access to neurologists and epilepsy subspecialists, patients’ ability to afford the drugs they need to control their seizures, and social limitations, such as the ability to travel to see specialists.
He cited a recent study he and his associates published that documented these barriers. They analyzed data collected from U.S. adults in 2010 and 2013 by the National Health Interview Survey run by the Centers for Disease Control and Prevention. That analysis showed that, when compared with the general U.S. adult population, people diagnosed with epilepsy were significantly less likely to be employed and more likely to be disabled. The epilepsy patients also reported relatively higher rates of inability to afford their medications, mental health care, eyeglasses, and dental care, and the patients also reported a relatively high rate of having transportation to health care as a barrier to receiving their care (Epilepsy Behav. 2015 Nov 25. doi: 10.1016/j.yebeh.2015.10.028). CDC data also showed that in 2010, 42% of U.S. adults with epilepsy and uncontrolled seizures had not been seen by a neurologist or epilepsy specialist during the preceding year.
The new report presented by Dr, Thurman at the meeting used U.S. claims data from patients of any age with private insurance or coverage through Medicare or Medicaid contained in the Truven Health Marketscan database during January 2011–June 2013. They identified 36,035 patients who appeared to have newly diagnosed epilepsy, of whom 17,106 received documented treatment for epilepsy during at least 1 year following their diagnosis. About a quarter of these patients had focal epilepsy, about a quarter generalized epilepsy, and about half had undefined epilepsy.
Among these 17,106 patients, 8,835 (52%) appeared to attain “treatment stability,” which the researchers defined as no changes in their antiepileptic drug regimen and no epilepsy-related hospitalizations in either the emergency department or as inpatients. About 42% of the patients reached stability with their first antiepileptic drug, another 6% reached stability with their second drug, and about 3% with their third drug, the researchers reported. The vast majority of patients who attained stability maintained it with monotherapy. Variables that linked with a greater likelihood of achieving treatment stability included older age, male sex, a history of a childhood psychiatric disorder, and having identified focal or generalized epilepsy rather than undefined epilepsy.
The study was funded by UCB. Dr. Thurman has been a consultant to and has received research funding from UCB.
On Twitter @mitchelzoler
PHILADELPHIA – Roughly half of U.S. patients newly diagnosed with epilepsy fail to receive a stable and effective treatment that keeps them seizure free during the first year following their diagnosis, according to an analysis of more than 17,000 incident epilepsy cases who received documented treatment with antiepileptic drugs and had at least 1 year of follow-up.
“Under the best health care circumstances, we can achieve full seizure control in two-thirds to 70% of patients, but the fact that we fall way short points to a treatment gap,” said Dr. David J. Thurman, a neurologist and epilepsy specialist who practices in Atlanta and is affiliated with Emory University. “We’re doing a lousy job,” he said in an interview while presenting a poster at the annual meeting of the American Epilepsy Society.
Dr. Thurman suggested that several factors likely contribute to epilepsy patients receiving less than ideal care, including their access to neurologists and epilepsy subspecialists, patients’ ability to afford the drugs they need to control their seizures, and social limitations, such as the ability to travel to see specialists.
He cited a recent study he and his associates published that documented these barriers. They analyzed data collected from U.S. adults in 2010 and 2013 by the National Health Interview Survey run by the Centers for Disease Control and Prevention. That analysis showed that, when compared with the general U.S. adult population, people diagnosed with epilepsy were significantly less likely to be employed and more likely to be disabled. The epilepsy patients also reported relatively higher rates of inability to afford their medications, mental health care, eyeglasses, and dental care, and the patients also reported a relatively high rate of having transportation to health care as a barrier to receiving their care (Epilepsy Behav. 2015 Nov 25. doi: 10.1016/j.yebeh.2015.10.028). CDC data also showed that in 2010, 42% of U.S. adults with epilepsy and uncontrolled seizures had not been seen by a neurologist or epilepsy specialist during the preceding year.
The new report presented by Dr, Thurman at the meeting used U.S. claims data from patients of any age with private insurance or coverage through Medicare or Medicaid contained in the Truven Health Marketscan database during January 2011–June 2013. They identified 36,035 patients who appeared to have newly diagnosed epilepsy, of whom 17,106 received documented treatment for epilepsy during at least 1 year following their diagnosis. About a quarter of these patients had focal epilepsy, about a quarter generalized epilepsy, and about half had undefined epilepsy.
Among these 17,106 patients, 8,835 (52%) appeared to attain “treatment stability,” which the researchers defined as no changes in their antiepileptic drug regimen and no epilepsy-related hospitalizations in either the emergency department or as inpatients. About 42% of the patients reached stability with their first antiepileptic drug, another 6% reached stability with their second drug, and about 3% with their third drug, the researchers reported. The vast majority of patients who attained stability maintained it with monotherapy. Variables that linked with a greater likelihood of achieving treatment stability included older age, male sex, a history of a childhood psychiatric disorder, and having identified focal or generalized epilepsy rather than undefined epilepsy.
The study was funded by UCB. Dr. Thurman has been a consultant to and has received research funding from UCB.
On Twitter @mitchelzoler
PHILADELPHIA – Roughly half of U.S. patients newly diagnosed with epilepsy fail to receive a stable and effective treatment that keeps them seizure free during the first year following their diagnosis, according to an analysis of more than 17,000 incident epilepsy cases who received documented treatment with antiepileptic drugs and had at least 1 year of follow-up.
“Under the best health care circumstances, we can achieve full seizure control in two-thirds to 70% of patients, but the fact that we fall way short points to a treatment gap,” said Dr. David J. Thurman, a neurologist and epilepsy specialist who practices in Atlanta and is affiliated with Emory University. “We’re doing a lousy job,” he said in an interview while presenting a poster at the annual meeting of the American Epilepsy Society.
Dr. Thurman suggested that several factors likely contribute to epilepsy patients receiving less than ideal care, including their access to neurologists and epilepsy subspecialists, patients’ ability to afford the drugs they need to control their seizures, and social limitations, such as the ability to travel to see specialists.
He cited a recent study he and his associates published that documented these barriers. They analyzed data collected from U.S. adults in 2010 and 2013 by the National Health Interview Survey run by the Centers for Disease Control and Prevention. That analysis showed that, when compared with the general U.S. adult population, people diagnosed with epilepsy were significantly less likely to be employed and more likely to be disabled. The epilepsy patients also reported relatively higher rates of inability to afford their medications, mental health care, eyeglasses, and dental care, and the patients also reported a relatively high rate of having transportation to health care as a barrier to receiving their care (Epilepsy Behav. 2015 Nov 25. doi: 10.1016/j.yebeh.2015.10.028). CDC data also showed that in 2010, 42% of U.S. adults with epilepsy and uncontrolled seizures had not been seen by a neurologist or epilepsy specialist during the preceding year.
The new report presented by Dr, Thurman at the meeting used U.S. claims data from patients of any age with private insurance or coverage through Medicare or Medicaid contained in the Truven Health Marketscan database during January 2011–June 2013. They identified 36,035 patients who appeared to have newly diagnosed epilepsy, of whom 17,106 received documented treatment for epilepsy during at least 1 year following their diagnosis. About a quarter of these patients had focal epilepsy, about a quarter generalized epilepsy, and about half had undefined epilepsy.
Among these 17,106 patients, 8,835 (52%) appeared to attain “treatment stability,” which the researchers defined as no changes in their antiepileptic drug regimen and no epilepsy-related hospitalizations in either the emergency department or as inpatients. About 42% of the patients reached stability with their first antiepileptic drug, another 6% reached stability with their second drug, and about 3% with their third drug, the researchers reported. The vast majority of patients who attained stability maintained it with monotherapy. Variables that linked with a greater likelihood of achieving treatment stability included older age, male sex, a history of a childhood psychiatric disorder, and having identified focal or generalized epilepsy rather than undefined epilepsy.
The study was funded by UCB. Dr. Thurman has been a consultant to and has received research funding from UCB.
On Twitter @mitchelzoler
AT AES 2015
Key clinical point: A sample of newly diagnosed U.S. epilepsy patients showed about half failed to have first-year treatment stability, an indicator that many patients receive suboptimal care.
Major finding: During 2011-2013, about 52% of Americans newly diagnosed with epilepsy achieved treatment “stability.”
Data source: Retrospective review of 17,106 newly diagnosed U.S. epilepsy patients contained in the Truven Health Marketscan database.
Disclosures: The study was funded by UCB. Dr. Thurman has been a consultant to and has received research funding from UCB.
