Antiepileptic Drug Titration and Related Health Care Resource Use and Costs

Journal of Managed Care & Specialty Pharmacy
Jesse FishmanImane Wild

Abstract

Unexpected breakthrough seizures resulting from suboptimal antiepileptic drug (AED) dosing during the titration period, as well as adverse events resulting from rapid AED titration, may influence the titration schedule and significantly increase health care resource use (HRU) and health care costs. To assess the relationship between AEDs, HRU, and costs during AED titration and maintenance. Practicing neurologists were recruited from a nationwide panel to provide up to 3 patient records each for this retrospective medical chart review. Patients with epilepsy who were aged ≥ 18 years and had initiated an AED between January 1, 2014, and January 1, 2016, were followed for 6 months from AED initiation. Titration duration was the time from AED initiation to the beginning of treatment maintenance as determined by the physician. Outcomes were epilepsy-specific HRU (hospitalizations, emergency department visits, outpatient visits, physician referral, laboratory testing/diagnostic imaging, and phone calls) and related costs that occurred during the titration or maintenance treatment periods. Of 811 patients, 156, 128, 125, 120, 114, 107, and 61 initiated the following AEDs: levetiracetam, lamotrigine, lacosamide, valproate, topiramate,...Continue Reading

References

Feb 24, 2001·The Annals of Pharmacotherapy·V BitonUNKNOWN Topiramate TPS-TR Study Group
Aug 19, 2004·Epilepsia·Josemir W Sander
Oct 22, 2005·Acta Neurologica Scandinavica. Supplementum·J W Sander
Jul 16, 2010·Neuropsychiatric Disease and Treatment·David M Treiman
May 11, 2012·Neurology·M J BrodieP Kwan
Nov 19, 2013·Epilepsy & Behavior : E&B·Joyce A CramerMichael S Broder
Aug 11, 2015·Epilepsy & Behavior : E&B·Victoria DivinoCharles Makin
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Nov 27, 2016·Epilepsia·David J ThurmanUNKNOWN Epidemiology Commission of the International League Against Epilepsy
Aug 11, 2017·MMWR. Morbidity and Mortality Weekly Report·Matthew M Zack, Rosemarie Kobau

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Citations

Dec 7, 2019·Advances in Therapy·Saku VäätäinenReetta Kälviäinen
Apr 3, 2021·Therapeutic Advances in Drug Safety·Aisling R Caffrey, Eric P Borrelli

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