Quality of life in adults with epilepsy is associated with anticonvulsant polypharmacy independent of seizure status
Quality of life in adults with epilepsy is associated with anticonvulsant polypharmacy independent of seizure status
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DOI：
10.1016/j.yebeh.2017.11.006
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发表时间：
2018-01-01
影响因子：
2.6
通讯作者：
Quigg, Mark
中科院分区：
文献类型：
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作者：
Alexander, Halley B.;Broshek, Donna K.;Quigg, Mark
理由：多种药物治疗有时是控制癫痫所必需的，可能会导致可能影响生活质量（QOL）的不良反应。我们的目的是确定多药治疗与QOL.Methods的关联：207例癫痫患者在过去4周内的特点进行了调查：癫痫患者加权生活质量（QOLIE-10-P）和癫痫发作状态（无或无癫痫），人口统计学，癫痫特征，失眠，嗜睡，情绪，睡眠-觉醒时间，医疗保健使用，和就业。那些服用多种药物的人（抗癫痫药物（AED）> 1）与对照组（AED = 1）进行单变量比较和随后的多变量回归。多种药物治疗的患者生活质量评分更差（平均33.3 +/- 6.9对36.7 +/- 5.7），不太可能无睡眠障碍（39（44%）对82（68%）），有更多的夜间加权清醒，更有可能失业（74%对49%）。即使在控制癫痫发作状态后，多种药物治疗仍与较差的QOL相关（比值比1.068和95 th CI 1.018-1.121）。协变量提供了没有改善model.Conclusion：多药治疗与癫痫患者的生活质量较差，尽管癫痫发作控制。为了发展最佳治疗的范例，需要进一步研究多种药物对生活质量影响的具体病因。(C)2017爱思唯尔公司All rights reserved.
Rationale: Polypharmacy, sometimes necessary to control epilepsy, can result in adverse effects that may affect quality of life (QOL). Our purpose was to determine the association of polypharmacy with QOL.Methods: Two hundred seven patients with epilepsy were surveyed on characteristics within the last 4 weeks: QOL Quality of Life in Epilepsy-Patient-Weighted (QOLIE-10-P) and seizure status (seizure-free or not), demo-graphics, epilepsy characteristics, insomnia, sleepiness, mood, sleep-wake timing, healthcare use, and employment. Those on polypharmacy (antiepileptic drug (AED) > 1) were compared with controls (AED = 1) with univariate comparisons and subsequent multivariate regression.Results: Patients on polypharmacy had worse QOL scores (mean 33.3 +/- 6.9 versus 36.7 +/- 5.7), were less likely to be seizure-free (39 (44%) versus 82 (68%)), had more evening-weighted wakefulness, and were more likely unemployed (74% versus 49%). Polypharmacy was associated with worse QOL (odds ratio 1.068 and 95th CI 1.018-1.121) even after controlling for seizure status. Covariates offered no improvement to the model.Conclusion: Polypharmacy was associated with worse QOL in patients with epilepsy despite seizure control. Further investigation into specific etiology of polypharmacy's influence on QOL is warranted in order to develop paradigms for optimal treatment. (C) 2017 Elsevier Inc. All rights reserved.