Association of Race and Geographic Region with Antiepileptic Drug Use Among Elderly Nursing Home Residents
Abstract number :
3.262
Submission category :
Year :
2000
Submission ID :
2495
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Susan Lee Harms, Nancy A Hardie, Judith Garrard, Cynthia R Gross, Patricia C Bland, Nicole M Nitz, Ilo E Leppik, Univ of Minnesota, Minneapolis, MN; Minnesota Comprehensive Epilepsy Program (MINCEP), Minneapolis, MN.
Rationale: The purpose of this study was to examine the association between AED use and race and region among elderly nursing home residents, a topic that has been under studied in the literature. Specifically, is there differential use of AEDs by racial/ethnic groups within geographic regions of the US? Methods: Subjects were all new admissions ?65 years of age (N = 10,318) who entered nursing homes (NH) owned or operated by Beverly Enterprises, Inc. during the period January through March 1999. Designation of geographic regions corresponds to US Bureau of the Census standards, and the NH sample covers a 32-state area. Data were gathered from the Minimum Data Set and physician order records for each resident and analyzed by logistic regression. The dependent variable was current use of an AED at NH entry. Results: Results indicate that race and region alone are both significantly (p < 0.05) associated with AED use, although the interaction term race*region was not a significant factor. Compared to NH residents in the northeast, subjects in the west were less likely to use AEDs (OR = 0.69; CI = 0.53, 0.90). The difference in AED use for southern and mid-western residents was not significant, although results suggest greater AED use among southern subjects and less use among mid-western elderly. Compared to Whites, AED use among Blacks (OR = 0.59; CI = 0.52, 0.67) was significantly less, as was use among Asians/Pacific Islanders (OR = 0.33; CI = 0.14, 0.78). Hispanics and American Indians/Alaskan Natives also showed lower use, although the differences were not statistically significant. Discussion: Prevalence of AED use by elderly NH admissions is associated with both race and region, although the association with race is more pronounced. AED use among Blacks is 40% less than the reference group, Whites, while Asians/Pacific Islanders show 67% less use. Results suggest the need for future research that examines the constellation of variables describing AED use within racial/ethnic groups. Study supported in part by NIH-NINDS grant #P50-NS16308.