Abstracts

Rationale: To identify prescribing trends of antiepileptic drugs (AEDs) in the Veteran Health Administration (VHA) population for Veterans with Epilepsy during Fiscal Year 2014 (FY14). Methods: Veterans with Epilepsy were defined as those prescribed an AED for at least 30 days during FY14, active seizure status on their problem list, and a documented seizure diagnosis between FY12-FY14. Demographic information collected for each Veteran included age, gender and OEF/OIF/OND (Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn) status. Age was categorized into those < 45 years of age, those 65 years of age or older, and those in between. AEDs were divided between older AEDs versus newer AEDs. Results: In the final analysis, 68,308 Veterans with Epilepsy were studied for FY14. The majority, 92.9%, were males. OEF/OIF/OND comprised 5.9% of the population. The most commonly prescribed AED was levetiracetam (38.7%). Phenytoin (28.4%) and valproate (15.5%) were the next most common AEDs prescribed. While the distribution of levetiracetam prescriptions was similar across age groups, phenytoin usage was highest (34.9%) in those at least 65 years of age. There were significant percentage differences between genders for lamotrigine (22% women versus 12.9% males) and topiramate (26.1% women versus 7.5% males). The majority (60.9%) of patients were prescribed monotherapy. Overall, 43.9% were prescribed only newer AEDs and this was more common in women (60.5% versus 42.7%). Conclusions: The most common AED prescribed was levetiracetam, among all demographics, reflecting a transition towards prescribing newer AEDs. Phenytoin was next most common, particularly in older male Veterans and may represent those with longstanding controlled epilepsy. Female Veterans were more likely to be prescribed newer AEDs, particularly lamotrigine and topiramate, reflecting gender awareness in prescribing habits. Funding: No funding was received.