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Antiepileptic drug use in seven electronic health record databases in E urope: A methodologic comparison
Author(s) -
Groot Mark C. H.,
Schuerch Markus,
Vries Frank,
Hesse Ulrik,
Oliva Belén,
Gil Miguel,
Huerta Consuelo,
Requena Gema,
Abajo Francisco,
Afonso Ana S.,
Souverein Patrick C.,
Alvarez Yolanda,
Slattery Jim,
Rottenkolber Marietta,
Schmiedl Sven,
Van Dijk Liset,
Schlienger Raymond G.,
Reynolds Robert,
Klungel Olaf H.
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12557
Subject(s) - medicine , european union , demography , population , pediatrics , database , danish , family medicine , environmental health , linguistics , philosophy , sociology , computer science , business , economic policy
Summary Objective The annual prevalence of antiepileptic drug ( AED ) prescribing reported in the literature differs considerably among E uropean countries due to use of different type of data sources, time periods, population distribution, and methodologic differences. This study aimed to measure prevalence of AED prescribing across seven E uropean routine health care databases in S pain, D enmark, The N etherlands, the U nited K ingdom, and Germany using a standardized methodology and to investigate sources of variation. Methods Analyses on the annual prevalence of AED s were stratified by sex, age, and AED . Overall prevalences were standardized to the European 2008 reference population. Results Prevalence of any AED varied from 88 per 10,000 persons (The N etherlands) to 144 per 10,000 in S pain and D enmark in 2001. In all databases, prevalence increased linearly: from 6% in D enmark to 15% in S pain each year since 2001. This increase could be attributed entirely to an increase in “new,” recently marketed AED s while prevalence of AED s that have been available since the mid‐1990s, hardly changed. AED use increased with age for both female and male patients up to the ages of 80 to 89 years old and tended to be somewhat higher in female than in male patients between the ages of 40 and 70. No differences between databases in the number of AED s used simultaneously by a patient were found. Significance We showed that during the study period of 2001–2009, AED prescribing increased in five European Union ( EU) countries and that this increase was due entirely to the newer AED s marketed since the 1990s. Using a standardized methodology, we showed consistent trends across databases and countries over time. Differences in age and sex distribution explained only part of the variation between countries. Therefore, remaining variation in AED use must originate from other differences in national health care systems. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here .