Changes in antiepileptic drug prescriptions over a decade in childbearing women in Lombardy region, Italy
Changes in antiepileptic drug prescriptions over a decade in childbearing women in Lombardy region, Italy
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DOI：
10.1111/bcp.15053
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发表时间：
2021-09-13
影响因子：
3.4
通讯作者：
Bonati, Maurizio
中科院分区：
文献类型：
--
作者：
Clavenna, Antonio;Campi, Rita;Bonati, Maurizio
目的描述2010-2019年期间意大利伦巴第大区孕妇和育龄妇女的抗癫痫药物（AED）处方模式。方法分析伦巴第大区行政卫生保健数据库（2010-2019年）。AED被归类为属于解剖治疗化学分类系统N 03 A亚组的药物。15-49岁的妇女被认为是育龄妇女，而怀孕期间的暴露估计考虑到分娩前12个月（国际疾病分类，第九次修订，临床修订，诊断记录中的ICD-9-CM代码为650 - 659）。结果2019年，16605名育龄妇女（患病率：14.8 ‰）至少接受了1次AED处方。普瑞巴林是育龄妇女中使用最广泛的抗癫痫药物（22.3%），其次是丙戊酸（20.0%）。2010年，育龄妇女丙戊酸处方的流行率为30.2%; 2019年为20.0%。在孕妇中，2010年的患病率为24.9%，2019年为14.1%。从2017年开始，左乙拉西坦和拉莫三嗪是孕妇最常用的药物。结论尽管丙戊酸处方随着时间的推移而减少，但该药物仍然是最常用的AED之一，特别是在育龄妇女中。需要对医疗保健专业人员和妇女进行教育干预，以减少意外怀孕的风险。
Aims To describe the antiepileptic drug (AED) prescription pattern in pregnant women and women of childbearing age in the 2010-2019 period in the Lombardy region, Italy. Methods The Lombardy region administrative healthcare databases (2010-2019) were analysed. AEDs were classified as drugs belonging to the N03A subgroup of the Anatomical Therapeutic Chemical Classification System. Women aged 15-49 years were considered as being of childbearing age, while exposure during pregnancy was estimated taking into account the 12 months before delivery (International Classification of Diseases, Ninth Revision, Clinical Modification, ICD-9-CM codes in the diagnosis record from 650 to 659). Results During 2019, 16 605 women of childbearing age (prevalence: 14.8 parts per thousand) received at least 1 AED prescription. Pregabalin was the most widely used antiepileptic in women of childbearing age (22.3%), followed by valproic acid (20.0%). In 2010, the prevalence of valproic acid prescription to women of childbearing age was 30.2%; in 2019 this was 20.0%. In pregnant women, this prevalence was 24.9% in 2010 and 14.1% in 2019. Starting from 2017, levetiracetam and lamotrigine were the most commonly drugs prescribed to pregnant women. Conclusion Despite the decrease in valproic acid prescription over time, this drug is still among the most used AEDs, in particular in women of childbearing age. Educational interventions for healthcare professionals and women are needed in order to reduce the risk of unplanned pregnancy.