Epilepsy Prevalence in the Veterans Health Administration
Abstract number :
2.383
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2204038
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Rizwana Rehman, PhD – Veterans Health Administration; Alan Towne, MD, MPH – National Director, Veterans Health Administration, Epilepsy Centers of Excellence
Rationale: One of the Veterans Health Administration Epilepsy Centers of Excellence (VHA ECoE) missions is to obtain accurate estimates of disease frequency measures in the VHA for surveillance and distribution of resources. Using a validated algorithm, the ECoE estimated the FY21 (October 1, 2020 - September 30, 2021) prevalence of epilepsy in the VHA.
Methods: Using the VHA Support Service Center (VSSC) Neurology Cube Patients were included (1) if prescribed an anti-seizure medication (ASM) in FY21 cross matched with a seizure diagnosis (ICD-10-CM G40.*, R40.4, R56.1, R56.9) during FY19-FY21. (2) with an inpatient encounter with seizure diagnosis G40.* during FY21, no cross match with an ASM required (3) with at least two outpatient encounters on two different dates with seizure diagnosis G40.* during FY21, no cross match with an ASM required. Diagnoses data from EEG and LTM clinics were excluded. Demographic variables, comorbidities and ASM data were evaluated.
Results: A total of 79,871 individuals were identified as epilepsy patients. Most were males (90.2%) and geriatric: age ≥65 years (55.3%). Approximately 33% patients belonged to rural areas. Whites were 69.6% and African American 21.5%. The Operation Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) Veterans comprised 6.5% of the epilepsy population. The most commonly prescribed ASMs were levetiracetam (43.5%), gabapentin (26.2%) and lamotrigine (13.0%). Topiramate was prescribed to 21.8% of females. PTSD was the most common comorbidity (28.1%), and 13.6% patients had a reported TBI. The overall estimated prevalence per 1,000 was 11.9, males: 12.5 and females: 8.3. Among the OEF/OIF/OND Veterans the estimate of prevalence was 8.7 per 1,000.
Conclusions: It is imperative to provide specialty care access to epilepsy patients living in rural areas. Similarly, as topiramate is linked to teratogenicity, providers should communicate this risk with all potential patients of child-bearing age. Continuous surveillance of epilepsy patients in the VHA is vital for optimal care and appropriate allocation of resources. In this regard, ECoE can play a pivotal role for the optimal specialty care of epilepsy patients in the VHA.
Funding: Not applicable
Epidemiology