Abstracts

Rationale: Although many new antiepileptic drugs (AEDs) have recently been developed, there is limited research examining predictors of antiepileptic treatment satisfaction. In particular, few studies examine patient and health characteristics, such as seizure frequency, along with treatment type in one treatment satisfaction model. Thus, this study aims to examine treatment type (monotherapy vs. adjunctive therapy), patient, and health characteristics as predictors of antiepileptic treatment satisfaction among patients with epilepsy.Methods: Data from the 2011-2013 U.S. National Health and Wellness Survey (NHWS) were analyzed. The NHWS is a self-administered, Internet-based survey of a nationwide sample of adults stratified to represent the demographic composition of the U.S. population. Patients who self-reported being treated with an AED for epilepsy were grouped as using monotherapy (one AED) or adjunctive AED therapy (two, three, four or more AEDs). Patients provided information on treatment satisfaction with current AED treatment (1 [extremely dissatisfied] to 7 [extremely satisfied]), demographics (age, ethnicity, and education), and health characteristics (BMI, comorbidities [Charlson comorbidity index], epilepsy severity, and frequency of seizures). Generalized linear models examined number of AEDs, as well as the aforementioned patient demographics and health characteristics as potential predictors of antiepileptic treatment satisfaction.Results: Among 1,126 epilepsy patients (mean age=46.33; 47.70% female), 744 were on monotherapy (66.07%), 286 on two AEDs (25.40%), 65 on three AEDs (5.77%), and 31 on four or more AEDs (2.75%). Controlling simultaneously for other potential predictors, monotherapy (b=0.686, 95% CI:0.205-1.17, p=0.005) and two AEDs (b=0.649, 95% CI:0.159-1.14, p=0.009) predicted higher treatment satisfaction compared with four or more AEDs. Among the patient demographic and health characteristic variables, older age (b=0.063, 95% CI:0.011-0.115, p=0.018), obese BMI (b=0.269, 95% CI:0.080-0.457, p=0.005), and lower frequency of seizures (once a week or more: b=-0.833, 95% CI:-1.09- -0.575, p<0.001; 2-3 times a month/every 6 months: b=-0.490, 95% CI:-0.671- -0.308, p<0.001) significantly predicted higher treatment satisfaction.Conclusions: In this regression analysis of a nationally representative sample of patients with epilepsy, treatment with one or two AEDs, older age, obese BMI, and lower frequency of seizures independently predicted higher treatment satisfaction. Conversely, education, ethnicity, comorbidities, and seizure severity did not predict treatment satisfaction. These findings may help inform clinicians about the different variables that potentially play a role in determining patients’ treatment satisfaction, as they continue to optimize epilepsy treatment plans. Sunovion Pharmaceuticals Inc. provided funding for this analysis.