title: Anticonvulsant prescription patterns in patients covered by the Colombian Health System.
abstract: BACKGROUND
  Epilepsy is a group of long-term neurological disorders characterised by seizures that may respond to pharmacological treatment.
  
  
  OBJECTIVE
  Determine the prescribing patterns of anticonvulsants for patients covered by the healthcare system in Colombia.
  
  
  METHODS
  Cross-sectional study using a database containing 6.5 million people. From among residents in 88 Colombian cities, we selected patients of both sexes and all ages who were treated continuously with anticonvulsants between June and August 2012. We designed a drug consumption database and performed multivariate analysis for combination treatment and co-medication using SPSS 20.0.
  
  
  RESULTS
  A total of 13,793 patients with mean age of 48.9±22.0 years were studied; 52.9% of the participants were women. Of the patient total, 74.4% were treated in monotherapy and 25.6% received two or more anticonvulsants. Globally, 72.9% of the patients were initially treated with classic anticonvulsants and 27.1% with new drugs. The most frequently used drugs were valproic acid (33.3%), carbamazepine (30.2%), clonazepam (15.7%), pregabalin (10.3%), phenytoin (10.0%) and levetiracetam (7.9%). Most agents were used in higher doses than recommended. The most common combinations were valproic acid+clonazepam (10.9%), valproic acid+carbamazepine (10.0%), carbamazepine+clonazepam (5.6%), valproic acid+phenytoin (4.4%). The most frequently prescribed co-medications were antihypertensives (61.0%), lipid-lowering drugs (45.8%), antidepressants (36.7%), antipsychotics (20.1%), anxiolytics (7.9%), and lithium (1.8%).
  
  
  CONCLUSIONS
  Doctors predominantly prescribe drugs with a high therapeutic value and favour anticonvulsant monotherapy. Most agents were used in higher doses than recommended. This underlines the need to design educational strategies addressing these prescribing habits, and to undertake research on the effectiveness of treatment.
authors.affiliation: Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia. Departamento de Ciencias Básicas, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia.
authors.forename: C D
authors.initials: CD
authors.lastname: Morales-Plaza
authors.affiliation: Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A., Pereira, Colombia. Electronic address: machado@utp.edu.co.
authors.forename: J E
authors.initials: JE
authors.lastname: Machado-Alba
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D003105:Colombia; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'
chemical_list: D000927:Anticonvulsants
keywords: Anticonvulsants; Anticonvulsivantes; Carbamazepina; Carbamazepine; Clonazepam; Colombia; Colombia (fuente DeCS); Drug prescription; Epilepsia; Epilepsy; Farmacoepidemiología; Fenitoína; Pharmacoepidemiology; Phenytoin; Prescripciones de medicamentos; Valproic acid; Ácido valproico