Characterising people with focal drug-resistant epilepsy: A retrospective cohort study

癫痫 医学 队列 左乙拉西坦 萧条(经济学) 共病 儿科 回顾性队列研究 欧洲联盟 精神科 队列研究 拉莫三嗪 内科学 经济 宏观经济学 业务 经济政策
作者
Caroline Benoist,Simona Boccaletti,John Paul Leach,Agnese Cattaneo,Anna B. Chaplin,Luís Antunes,Franca Heiman,Josemir W. Sander
出处
期刊:Epilepsy & Behavior [Elsevier]
卷期号:149: 109540-109540 被引量:2
标识
DOI:10.1016/j.yebeh.2023.109540
摘要

To describe the demographics, clinical characteristics, drug treatment outcomes, healthcare resource utilization, and injuries among people with focal drug-resistant epilepsy (F-DRE) analysed separately for six European countries.We used electronic medical record data from six European (Belgium, Spain, Italy, France, UK and Germany) primary care/specialist care databases to identify antiseizure medication (ASM) treatment-naïve people (aged ≥ 18 years at F-DRE diagnosis). They were followed from their epilepsy diagnosis until death, the date of last record available, or study end. We used descriptive analyses to characterise the F-DRE cohort, and results were reported by country.One-thousand-seventy individuals with F-DRE were included (mean age 52.5 years; 55.4 % female). The median follow-up time from the first diagnosis to the end of the follow-up was 95.5 months across all countries. The frequency of F-DRE diagnosis in 2021 ranged from 8.8 % in Italy to 18.2 % in Germany. Psychiatric disorders were the most common comorbidity across all countries. Frequently reported psychiatric disorders were depression (26.7 %) and anxiety (11.8 %). The median time from epilepsy diagnosis to the first ASM failure ranged from 5.9 (4.2-10.2) months in France to 12.6 (5.8-20.4) months in Spain. Levetiracetam and lamotrigine were the most commonly used ASM monotherapies in all countries. Consultation with a general practitioner is sought more frequently after F-DRE diagnosis than after epilepsy diagnosis, except in the UK.No one ASM is optimal for all people with F-DRE, and the risks and benefits of the ASM must be considered. Comorbidities must be an integral part of the management strategy and drive the choice of drugs.
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