title: Indications of newer and older anti-epileptic drug use: findings from a southern Italian general practice setting from 2005-2011.
abstract: OBJECTIVE
  The aim of the study was to analyze the prescribing pattern of both newer and older AEDs.
  
  
  METHODS
  A population of almost 150 000 individuals registered with 123 general practitioners was included in this study. Patients who received at least one AED prescription over 2005-2011 were identified. The 1 year prevalence and cumulative incidence of AED use, by drug class and individual drug, were calculated over the study period. Potential predictors of starting therapy with newer AEDs were also investigated.
  
  
  RESULTS
  The prevalence of use per 1000 inhabitants of older AEDs increased from 10.7 (95% CI10.1, 11.2) in 2005 to 13.0 (95% CI12.4, 13.6) in 2011, while the incidence remained stable. Newer AED incidence decreased from 9.4 (95% CI 8.9, 9.9) in 2005 to 7.0 (95% CI 6.6, 7.5) in 2011, with a peak of 15.5 (95% CI 14.8, 16.1) in 2006. Phenobarbital and valproic acid were the most commonly prescribed AEDs as starting therapy for epilepsy. Gabapentin and pregabalin accounted for most new pain-related prescriptions, while valproic acid and lamotrigine were increasingly used for mood disorders. Female gender (OR 1.36, 95% CI 1.20, 1.53), age ranging between 45-54 years (OR 1.39, 95% CI 1.16, 1.66) and pain as an indication (OR 16.7, 95% CI, 13.1, 21.2) were associated with newer AEDs starting therapy.
  
  
  CONCLUSIONS
  Older AEDs were mainly used for epileptic and mood disorders, while newer drugs were preferred for neuropathic pain. Gender, age, indication of use and year of starting therapy influenced the choice of AED type. The decrease of newer AED use during 2007 is probably related to the restricted reimbursement criteria for gabapentin and pregabalin.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Domenico
authors.initials: D
authors.lastname: Italiano
authors.affiliation: Department of Experimental Medicine, Pharmacology Section, Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Second University of Naples, Naples.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
authors.affiliation: Department of Economics, Business, Environmental Science and Quantitative Methodologies, University of Messina, Messina.
authors.forename: Angela
authors.initials: A
authors.lastname: Alibrandi
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Rosarita
authors.initials: R
authors.lastname: Ferrara
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cannata
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trifirò
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Janet
authors.initials: J
authors.lastname: Sultana
authors.affiliation: Department of Experimental Medicine, Pharmacology Section, Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Second University of Naples, Naples.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ferrajolo
authors.affiliation: Caserta Local Health Service, Caserta, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Tari
authors.affiliation: Caserta Local Health Service, Caserta, Italy.
authors.forename: Daniele Ugo
authors.initials: DU
authors.lastname: Tari
authors.affiliation: Caserta Local Health Service, Caserta, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Perrotta
authors.affiliation: Caserta Local Health Service, Caserta, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pagliaro
authors.affiliation: Department of Experimental Medicine, Pharmacology Section, Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Second University of Naples, Naples.
authors.forename: Concita
authors.initials: C
authors.lastname: Rafaniello
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Spina
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Arcoraci
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016208:Databases, Factual; D016527:Drug Costs; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000191:economics / Q000639:trends*; D058005:General Practitioners / Q000191:economics / Q000639:trends*; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007349:Insurance, Health, Reimbursement; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy / Q000453:epidemiology; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends*; D015995:Prevalence; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics; D000927:Anticonvulsants; D014150:Antipsychotic Agents
keywords: anti-epileptics; general practice; incidence; indications of use; prescriptions; prevalence