Sociodemographic Disparities in Administration of

Authors: Hajo M Hamer Karel Kostev

Publish Date: 2014/07/09

Volume: 28, Issue: 8, Pages: 753-759

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Abstract

Large epidemiological databases facilitate the study of medical care in different subgroups of the population and how such care compares with standard treatment guidelines This study aimed for such analyses regarding utilization of antiepileptic drugs AEDs for epilepsy in GermanyThe data source was the Disease Analyzer® database that is representative for the German population and assembles anonymous demographic and medical diagnoses prescriptions data obtained from the practice computer system of general practitioners and specialists throughout Germany A total of 43712 adult patients with an epilepsy diagnosis International Classification of Diseases 10th edition ICD10 code G40X seen in 2010–2012 by 346 neurologists were retrospectively analysed according to sociodemographic characteristics comorbidity and AED treatment Multivariate logistic regression was applied to calculate adjusted odds ratios ORs with 95  confidence intervals CIsAs compared with women men were less likely to receive lamotrigine OR 068 95 CI 065–072 p  0001 and were treated preferably with carbamazepine OR 129 95 CI 123–135 p  0001 As compared with patients covered by private health insurance PHI patients with statutory health insurance SHI were treated more often with valproate OR 119 95 CI 107–131 p  0001 and showed a higher rate of obesity SHI 31  PHI 16  p  0001 while PHI was associated with administration of levetiracetam OR 127 95 CI 116–14 p  0001 Carbamazepine OR 125 95 CI 117–131 p  0001 and primidone OR 123 95 CI 108–138 p  0001 were administered to a larger extent in rural versus urban areas Lamotrigine OR 131 95 CI 123–139 p  0001 was used more often in West than in East Germany Living in an urban community raised the likelihood of being treated with levetiracetam OR 123 95 CI 117–128 p  0001Dr Hamer has served on the scientific advisory board of cerbomed Eisai Pfizer and UCB Pharma He served on the speakers’ bureau of Cyberonics Desitin Eisai GlaxoSmithKline Novartis and UCB Pharma and received research funding from Desitin JanssenCilag GlaxoSmithKline and UCB Pharma

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