Change in Prevalence of Chronic Conditions over a Period of 14 Years in Patients with Epilepsy (P07.123)

Abstract

Objective: To examine changes in the prevalence of chronic comorbid conditions in patients with epilepsy (PWE) over time. Background PWE have high prevalence of chronic conditions. However, temporal changes in the prevalence of these conditions remain unknown. Design/Methods: The Ohio Medicaid claims data from 1992 to 2008 was used to form a cohort of PWE and control. Individuals aged ≥18 year old with at least two years of look-back and follow-up periods were included. Our epilepsy cohort consisted of 6,390 individuals with at least one visit of a diagnosis of epilepsy (ICD-9-CM: 345.xx) or at least two visits of non-febrile convulsions (ICD-9-CM: 780.3 or 780.39) and at least one pharmacy dispensing of antiepileptic drugs. Control cohort consisted of 83,067 individuals without the diagnostic code of epilepsy or non-febrile convulsion. Individuals who enrolled in both Medicaid and Medicare programs or managed care program, who had a period of spend down, or who had less than 80% of expected enrollment were excluded. We measured the prevalence of 38 common conditions that were selected based on their commonality in the general population and their impact on the patient9s outcome every 2 year interval. Results: PWE had significantly higher prevalence of chronic comorbid conditions, especially during the first 10 years after epilepsy diagnosis. In generalized estimating equations logistic regression models adjusting for sex, race, age and time, PWE continued to have high prevalence of these conditions. Regression models demonstrated that the prevalence ratio of these conditions significantly decreased over time. However, the prevalence ratio of congestive heart failure;cardiac arrhythmia;peripheral vascular disorders;liver disease;coagulopathy;deficiency anemia;hypothyroidism;fluid and electrolyte disorders;paralysis and other neurological diseases other than epilepsy;weight loss;pain;depression;suicide;alcohol abuse;and psychosis remained >1 throughout a period of 14 years. Conclusions: PWE have several chronic comorbid conditions. These conditions put significant health risks to PWE. Supported by: The Epilepsy Foundation. Disclosure: Dr. Kaiboriboon has nothing to disclose. Dr. Bakaki has nothing to disclose. Dr. Sattar has nothing to disclose. Dr. Schiltz has nothing to disclose. Dr. Kosachunhanun has nothing to disclose. Dr. Koroukian has nothing to disclose.