Utilisation and polypharmacy aspects of antiepileptic drugs in elderly versus younger patients with epilepsy: A pharmacoepidemiological study of CNS-active drugs in Norway, 2004-2015
| Autor: | Pål G. Larsson, Erik Sætre, Silje Andrea Feet, Arton Baftiu, Cecilie Johannessen Landmark, Espen Molden, Oliver Henning, Anne Gerd Granås, Svein I. Johannessen, Margrete Larsen Burns |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Gabapentin medicine.medical_treatment Population Pregabalin 030226 pharmacology & pharmacy 03 medical and health sciences Epilepsy 0302 clinical medicine Internal medicine Humans Medicine Medical prescription Psychiatry Antipsychotic education Polypharmacy education.field_of_study Norway business.industry Age Factors Middle Aged Pharmacoepidemiology medicine.disease Antidepressive Agents Drug Utilization Neurology Neuralgia Anticonvulsants Neurology (clinical) business 030217 neurology & neurosurgery Antipsychotic Agents medicine.drug |
| Zdroj: | Epilepsy Research. 139:35-42 |
| ISSN: | 0920-1211 |
| Popis: | Background and purpose Many patients with epilepsy use antiepileptic drugs (AEDs) in combination. The elderly is a vulnerable group regarding polypharmacy. The purpose of this study was to investigate changes in utilisation of AEDs, and the extent of polypharmacy with other CNS-active drugs in elderly versus younger patients in Norway. Methods This pharmacoepidemiological study included all prescriptions of antiepileptic, antidepressant and antipsychotic drugs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2015). Variables included number of patients, utilisation in defined daily doses, age, gender, and diagnosis specific reimbursement codes for AEDs. Results The use of AEDs has increased in all age groups in this population-based study in Norway. In the elderly, AEDs used in neuropathic pain (mainly gabapentin and pregabalin) have increased more than 10-fold (from 0.7 to 9.6 DDDs/1000 elderly/day, 2004-2015), while the prevalence of users is four times more than in younger patients. Polypharmacy between antiepileptic, antidepressant and antipsychotic drugs occurred in 35% of elderly and 38% of younger patients with epilepsy. The use of enzyme-inducers was common, and occurred more often in elderly patients. A total of 42 different interactions that may have clinical implications were identified among these drugs. Conclusion The use of AEDs in elderly compared to younger patients is increasing, especially in neuropathic pain. Polypharmacy with antiepileptic, antidepressant and/or antipsychotic drugs was documented in more than one third of the patients. Awareness of increased drug utilisation, polypharmacy with potential drug interactions, and focus on elderly patients are important for increased patient safety. |
| Databáze: | OpenAIRE |
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