Sociodemographic differences in antiepileptic drug prescriptions to adult epilepsy patients
Sociodemographic differences in antiepileptic drug prescriptions to adult epilepsy patients
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DOI：
10.1212/wnl.0b013e3181cbcd5c
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发表时间：
2010-01-26
期刊：
影响因子：
9.9
通讯作者：
Weitoft, G. Ringback
中科院分区：
文献类型：
--
作者：
Mattsson, P.;Tomson, T.;Weitoft, G. Ringback
背景：根据瑞典《医疗保健法》，无论患者的社会人口状况如何，都应该为他们提供所需的医疗服务。我们调查了瑞典的社会人口学差异是否与获得专家医疗保健和抗癫痫药物(AED)处方治疗癫痫有关。在最近建立的瑞典处方药登记册中确定了2006年连续接受AED治疗18年的人员。关于社会人口变量的数据是从其他几个国家登记册中获得的。我们将数据联系起来，以检查癫痫患者寻求神经科医生的机会和开出个人AED的处方是否与性别、年龄、教育水平、居住地、出生地区或收入有关。我们还评估了与非神经科医生相比，神经科医生给癫痫患者开的AED是否不同。结果：我们在登记中确定了26,124名持续接受AED治疗的癫痫患者(有效样本)。女性、年轻、受过高等教育、高收入和居住在较大的城市意味着比其他专家更经常接受神经科医生的治疗。AEDs的处方因性别、年龄、教育程度、居住地和收入的不同而不同。拉莫三嗪和左乙拉西坦在更大程度上是由神经科医生开出的，而不是由其他专科医生开出的。结论：这项全国性的癫痫患者横断面研究表明，社会人口学特征对神经科医生的使用和个人抗癫痫药物的处方非常重要。需要使用与患者相关的结果进行前瞻性研究来分析这些差异的后果。神经病学(R)2010；74：295-301
Background: According to the Swedish Health Care Act, patients should be provided with the health care they need, regardless of sociodemographic status. We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in epilepsy.Method: Patients with epilepsy were identified in the National Patient Register. Persons >18 years on continuous AED treatment in 2006 were identified in the recently established Swedish Prescribed Drug Register. Data on sociodemographic variables were obtained from several other national registers. We linked data to examine whether epilepsy patients' access to neurologists and the prescription of individual AEDs are related to sex, age, educational level, area of residence, region of birth, or income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neurologists as compared to non-neurologists.Results: We identified 26,124 epilepsy patients in the register who were on continuous AED treatment ( effective sample). Being women, young, highly educated, having high incomes, and residing in a larger city meant being more often treated by a neurologist than by other specialists. The prescriptions of AEDs differed according to gender, age, education, place of residence, and income. Lamotrigine and levetiracetam were prescribed to a larger extent by a neurologist rather than by other specialists.Conclusions: This nationwide cross-sectional study of epilepsy patients indicates that sociodemographic characteristics are important for access to neurologists and prescriptions of individual antiepileptic drugs. Prospective studies using patient-related outcomes are needed to analyze the consequences of these differences. Neurology (R) 2010; 74: 295-301