Trends in antiepileptic drug treatment and effectiveness in clinical practice in England from 2003 to 2016: a retrospective cohort study using electronic medical records
| Autor: | Victor Alangibi Kiri, John Logan, Graham Powell, Simon Borghs |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Databases Factual Nice Lamotrigine Epilepsy Young Adult remission Health care medicine Electronic Health Records Humans seizure freedom Practice Patterns Physicians' Child computer.programming_language Aged Retrospective Studies Original Research drug resistance refractoriness business.industry Medical record Age Factors Retrospective cohort study General Medicine Guideline Middle Aged medicine.disease England Neurology treatment patterns Anticonvulsants Female Levetiracetam Guideline Adherence business computer medicine.drug |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectiveTo assess the evolution of antiepileptic drug (AED) treatment patterns and seizure outcomes in England from 2003 to 2016.Design, setting and participantsRetrospective cohort study of electronic medical records from Clinical Practice Research Datalink and National Health Service Digital Hospital Episode Statistics databases. Patients newly diagnosed with epilepsy were identified and followed until end of data availability. Three eras were defined starting 1 April 2003 (first National Institute for Health and Care Excellence (NICE) guideline); 1 September 2007 (Standard and New Antiepileptic Drugs publication); and 1 January 2012 (second NICE guideline).Outcome measuresTime from diagnosis to first AED; AED sequence; time from first AED to first 1-year remission period (no new AED attempts and no seizure-related healthcare events); time from first AED to refractoriness (third AED attempt regardless of reason); Kaplan-Meier analysis of time-to-event variables.Results4388 patients were included (mean follow-up: 6.8, 4.2 and 1.7 years by era). 84.6% of adults (≥16 years), 75.5% of children (ConclusionTreatment trends often were not aligned with era-relevant guidance. However, our results suggest a slight improvement in epilepsy treatment outcomes over the 13-year period. |
| Databáze: | OpenAIRE |
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