Antiepileptic drug use in nursing home residents: effect of age, gender, and comedication on patterns of use.
OBJECTIVE
Examine antiepileptic drug (AED) use in nursing homes by age, gender, and use of comedication that can interact with AEDs.


METHODS
Two point-prevalence evaluations of AED use from computerized medical records of nursing home residents throughout the United States (set 1, 43,757; set 2, 41,386) 65 years and older serviced by PHARMERICA.


RESULTS
10.5% of residents received an AED. Of the age group 65-84 years, 15 % received an AED compared with 6.1% of those 85 years or older (p < 0.001). Gender differences were present; 13.4% of the male residents and 9.4% of the female residents were treated with an AED (p < 0.001). The most frequently prescribed AEDs were phenytoin, carbamazepine, clonazepam, or phenobarbital. The average number of routine medications taken by AED recipients was 5.6, greater than the average of 4.6 for other residents.


CONCLUSIONS
AEDs are extensively prescribed for elderly nursing home residents. Men and persons aged 65-85 years were more likely to receive AEDs than were women or those older than 85 years. AED recipients receive more routine medications than do other residents, including co-medications that alter hepatic metabolism and clinical response. The reasons for age and gender differences are unclear and require further study.
Lackner
T E
TE
PharMerica, Fridley, Minnesota 55421, USA.
Cloyd
J C
JC
Thomas
L W
LW
Leppik
I E
IE
D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D004347:Drug Interactions; D004363:Drug Utilization; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010672:Phenytoin / Q000627:therapeutic use; D019338:Polypharmacy; D015995:Prevalence; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology; D012737:Sex Factors
D000927:Anticonvulsants; D002220:Carbamazepine; D010672:Phenytoin