title: Risk factors for antiepileptic drug regimen change in patients with newly diagnosed epilepsy.
abstract: This study aimed to investigate the evolution of treatment within patients with newly diagnosed epilepsy identified from a large US commercial health care database. Postdiagnosis, patient follow-up was divided into observation units defined by consecutive antiepileptic drug (AED) prescriptions. Consecutive prescriptions were compared to assess whether a change in AED regimen had occurred. Factors associated with a regimen change were explored using a logistic regression model with subject random effects. Among 5930 patients with newly diagnosed epilepsy, there was a median of one regimen change in the first year. However, patients prescribed polytherapy regimens early in the course of disease were at a substantially greater risk of a regimen change (polytherapy vs monotherapy odds ratio=10.2, 95% confidence interval=9.2-11.3). Although a seizure during the preceding 90 days significantly increased the risk of a regimen change, it was beyond the scope of the study to determine the proportion of changes directly attributable to uncontrolled seizures.
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Middlesex, UK. Marianne.C.Cunnington@gsk.com
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Cunnington
authors.forename: David J
authors.initials: DJ
authors.lastname: Webb
authors.forename: Michael C
authors.initials: MC
authors.lastname: Irizarry
authors.forename: Ranjani
authors.initials: R
authors.lastname: Manjunath
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants