Older Americans with Epilepsy Aren’t Getting the Care They Need, Study Says

Older Americans with Epilepsy Aren’t Getting the Care They Need, Study Says

Many older Americans who are newly diagnosed with epilepsy are receiving outdated anti-epileptic drugs (AEDs), and only half of these patients initiate treatment in a timely manner following diagnosis, a new report found. It suggests the healthcare services for such people are suboptimal and urges further investigation.

The study, “What does the U.S. Medicare administrative claims database tell us about initial antiepileptic drug treatment for older adults with new-onset epilepsy?,” appeared in the February issue of the journal Epilepsy. It tracked Medicare claims between 2008 and 2010 for a 5 percent random sample of beneficiaries.

“In this population of older adults on Medicare Part D drug coverage, we noted that while prescriptions of newer-line AEDs, in particular levetiracetam, are increasing compared with other studies of older Americans with epilepsy, there remains a substantial proportion receiving older-line AEDs, most notably phenytoin,” Maria Pisu, the study’s senior author, said in a press release.

“We cannot assess why this occurs from these data, but the use of newer AEDs with more favorable side-effect potential and lower risk for drug-drug interactions is particularly important in an older population with a significant number of co-occurring conditions,” Pisu added.

Importantly, the study found that treatment also gets delayed, with only half of newly diagnosed older epileptics receiving prompt care within 30 days of diagnosis.

One of the study’s main objectives was to assess differences in treatment across racial and ethnic groups, as disparities in epilepsy care had been reported before, according to the researchers. They wanted to find out if some groups were disproportionally suffering the consequences of this suboptimal treatment. Yet they found no major racial or ethnic disparities in AED prescription patterns.

“Minority groups seem to receive comparable AED treatment to whites, despite clear socioeconomic differences with the white counterparts,” Pisu said.

Pisu has published a series of epilepsy-related articles, including “Geographic variation of epilepsy for older Americans: How close to the geographic variation of stroke?” (2012) and “Psychiatric and neurologic risk factors for incident cases of new-onset epilepsy in older adults: Data from U.S. Medicare beneficiaries,” (2014).

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