Changes in Antiepileptic Drug Prescription Patterns for Adults with Epilepsy: A Retrospective Cross-Sectional Study in Hong Kong 2000 – 2019
Abstract number :
V.078
Submission category :
7. Anti-seizure Medications / 7E. Other
Year :
2021
Submission ID :
1825825
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Isaac Khoo, MBBS - University of Hong Kong; Wing Sum Kwok, MBBS - University of Hong Kong; Sing Yuk Lam, MBBS - University of Hong Kong; William CY Leung, MRCP(UK) - Queen Mary Hospital; Richard Shek-kwan Chang, FRCP(HK) - Queen Mary Hospital
Rationale: Over the past two decades, major pharmaceutical advancements have resulted in the emergence of multiple novel antiepileptic drugs (AED). The public health care system in Hong Kong serves more than 90% of the population. It also has a liberal policy in AED prescription. We conducted a study to investigate the change of AED utility in recent two decades.
Methods: In this retrospective cross-sectional study, the central computerized database of local public hospitals was employed to identify all adult patients with diagnosis of epilepsy with AED prescription in both years of 2000 and 2019. All included patients must be aged 18 years or above, have a diagnostic coding of International Classification of Diseases-9 (ICD-9) of epilepsy and prescribed at least one AED. The percentage of AED use represented the number of individuals prescribed with that AED over the total population of patients with epilepsy in that year. Changes in prescription pattern were analyzed.
Results: A total of 14306 adults were included in this study—4966 adults in 2000, and 9340 adults in 2019. In 2000, 57.6% were male (mean age 52±20.5 years), and 42.4% were female (mean age 55±22.5 years). In 2019, 57.1% were male (mean age 57±18.6 years), and 42.9% were female (mean age 58±20.2 years). There were no significant differences in sex distribution over the years.
Prescription of Valproic Acid (VPA) had significant increase with 30% of individuals treated with it in 2000 compared to 41% individuals in 2019 (p < 0.01). Prescriptions of Lamotrigine (LTG) also increased from 2% to 6% (p < 0.01) during the same period. Between 2000 and 2019, there were significant decreases in the prescription of Phenytoin (PHT) from 41% to 15% (p < 0.01), and Carbamazepine (CBZ) from 31% to 15% (p < 0.01). Prescription of Levetiracetam (LEV), which was not available in the year 2000, became the most prescribed new-generation AED in 2019, accounting 24% of prescription. Only Phenobarbital (PB) had similar prescription rates over the years with 9% of patients receiving the drug in 2000, versus 8% in 2019.
Anti-seizure Medications