Editors' note: Assessment and effect of a gap between new-onset epilepsy diagnosis and treatment in the US

Abstract

In “Assessment and effect of a gap between new-onset epilepsy diagnosis and treatment in the US,” Kalilani et al. retrospectively reviewed claims data to determine the percentage of patients diagnosed with epilepsy who remained off antiepileptic drugs (AEDs) up to 3 years after diagnosis and the incidence of medical events and healthcare resource utilization for patients with epilepsy who were not prescribed AEDs. They found that one-third of patients diagnosed with epilepsy were untreated up to 3 years after diagnosis; this was associated with an adjusted incidence rate ratio of 1.2 (1.2–1.3) for medical events, 2.3 (2.2–2.3) for hospitalizations, and 2.8 (2.7–2.9) for emergency room visits. Sethi notes that the lack of treatment can be attributed to the inability to predict a given patient's course and desire to avoid unnecessarily subjecting patients to a lengthy regimen of AEDs and their associated side effects. Kalilani et al. agree with this hypothesis but emphasize their belief that the morbidity and mortality rate among patients diagnosed with epilepsy who are untreated is not acceptable and that clinicians must be aware of the consequences of delaying treatment. In “Assessment and effect of a gap between new-onset epilepsy diagnosis and treatment in the US,” Kalilani et al. retrospectively reviewed claims data to determine the percentage of patients diagnosed with epilepsy who remained off antiepileptic drugs (AEDs) up to 3 years after diagnosis and the incidence of medical events and healthcare resource utilization for patients with epilepsy who were not prescribed AEDs. They found that one-third of patients diagnosed with epilepsy were untreated up to 3 years after diagnosis; this was associated with an adjusted incidence rate ratio of 1.2 (1.2–1.3) for medical events, 2.3 (2.2–2.3) for hospitalizations, and 2.8 (2.7–2.9) for emergency room visits. Sethi notes that the lack of treatment can be attributed to the inability to predict a given patient's course and desire to avoid unnecessarily subjecting patients to a lengthy regimen of AEDs and their associated side effects. Kalilani et al. agree with this hypothesis but emphasize their belief that the morbidity and mortality rate among patients diagnosed with epilepsy who are untreated is not acceptable and that clinicians must be aware of the consequences of delaying treatment.