Low Income, Singlehood, and Race Tied to Seizure Control in Active Epilepsy

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The annual active epilepsy prevalence in 2013 and 2015 was 0.9% and 1.2%, respectively.
The annual active epilepsy prevalence in 2013 and 2015 was 0.9% and 1.2%, respectively.

A report published in Morbidity and Mortality Weekly Report demonstrates that more than half of active epilepsy patients on a current medication regimen still experience seizures. Patients most likely to suffer from seizures include individuals who are unemployed; have a lower household income; and are either divorced, separated, or widowed.

Investigators assessed reports from the National Health Interview Survey (NHIS) Sample Adult component from 2013 (n=34,557) and 2015 (n=33,672). Questions were asked that identified active epilepsy and assessed the level of specialty care each patient received. Investigators also assessed whether participants had visited a neurologist or epilepsy specialist in the past year, whether participants were on an epilepsy medication, and the percentage of seizures that were controlled during the past year.

The annual active epilepsy prevalence in 2013 and 2015 was 0.9% and 1.2%, respectively. Active epilepsy was more common in non-Hispanic white and non-Hispanic black patients; patients were never married; and patients who were divorced, separated, or widowed. In addition, individuals who had not completed a high school education, who were unemployed, or who came from lower-income families had a higher active epilepsy prevalence. Patients who had received direct care from an epilepsy specialist in the past year also reported higher prevalence of taking their epilepsy medication compared with patients not receiving this care (95.4% vs 78.1%, respectively).

The majority of participants (67%) reported seeing a neurologist or epilepsy specialist in the past year, with younger adults comprising a higher percentage of these participants. Approximately 44% of respondents reported having controlled seizures (ie, no seizures) within the past year. Older adults aged ≥65 (62.7%) were more likely to report seizure control vs adults age 35 to 54 (36.9%). In addition, seizure control was higher in individuals who were married vs not married (50.0% vs 31.5%, respectively), and individuals with high family income vs low family income (55.3% vs 32.2%, respectively). Greater seizure control in respondents taking medication was reported in the Northeast vs the South (60.3% vs 37.5%, respectively).

Limitations of the analysis included the reliance on self-reported data and the potential desirability bias among respondents.

The current public healthcare system “should ensure that adults with uncontrolled seizures have appropriate care and self-management support in order to promote seizure control, improve health and social outcomes, and reduce health care costs.”

Reference

Tian N, Boring M, Kobau R, Zack MM, Croft JB. Active epilepsy and seizure control in adults - United States, 2013 and 2015. MMWR Morb Mortal Wkly Rep. 2018;67(15):437-442.

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