Clinical and Economic Burden of Uncontrolled Epilepsy: Analyses From a Medicaid Database and a Private Health Plan Database
Information source: GlaxoSmithKline
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Epilepsy
Intervention: Anti-epileptic drug (AED) (Drug)
Phase: N/A
Status: Completed
Sponsored by: GlaxoSmithKline Official(s) and/or principal investigator(s): GSK Clinical Trials, Study Director, Affiliation: GlaxoSmithKline
Summary
Antiepileptic drugs (AEDs) are the main therapeutic option for patients with epilepsy;
however, complete seizure control remains elusive for many patients. Uncontrolled or
refractory epilepsy is associated with a higher risk of mortality, physical injuries, and
depression or anxiety compared with patients with controlled epilepsy. Higher resource
utilization for patients with poor control is likely to be associated with higher economic
costs. While diagnostic criteria for uncontrolled epilepsy are debated by neurologists,
recent studies suggest that a diagnosis of uncontrolled epilepsy requires 1.) at least one
seizure per month and 2.) a history of drug failures.
The objective of this study is to identify patients with uncontrolled epilepsy in both a
Medicaid database and a private health plan database, to describe patient characteristics
and AED treatment patterns between cohorts of patients with uncontrolled versus
well-controlled epilepsy, and to evaluate the economic burden of uncontrolled versus
well-controlled epilepsy.
For this evaluation, the data sources are medical and pharmacy claims in Medicaid databases
from Florida (Third quarter 1997 to second quarter 2008), Iowa (First quarter 1998 to second
quarter 2006), Kansas (First quarter 2001 to second quarter 2009), Missouri (First quarter
1997 to second quarter 2008) and New Jersey (First quarter 1997 to fourth quarter 2008) and
medical and pharmacy claims in an private health plan database.
The study design is a retrospective, longitudinal, matched-cohort study. Eligible patient
records will be assigned to one of three mutually-exclusive cohorts: uncontrolled epilepsy
(at least 2 consecutive changes in AED therapy in at least 30 days, and at least 1
epilepsy-related inpatient or emergency department (ED) visit within 365 days),
well-controlled epilepsy (no AED changes and no epilepsy-related inpatient or ED visits),
and intermediate epilepsy (not classified as uncontrolled or well-controlled).
Clinical Details
Official title: Clinical and Economic Burden of Uncontrolled Epilepsy: Analyses From a Medicaid Database and a Private Health Plan Database
Study design: Observational Model: Cohort, Time Perspective: Retrospective
Primary outcome: Average Annualized Costs
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- At least 18 years of age at the initiation of anti-epileptic drug (AED) treatment as
noted in the database
- A record of at least one medical visit with a diagnosis of epilepsy (ICD-9-CM 345. xx)
or at least two diagnoses of non-febrile convulsions (ICD-9-CM 780. 30 or 780. 39)
occuring more than 30 days apart
- At least one pharmacy claim for an anti-epileptic drug (AED)
- Continuous enrollment throughout the observation period (minimum of 365 days).
Patients with gaps in Medicaid enrollment will be observed only during their period
of continuous enrollment, provided that all the above criteria are met
Exclusion Criteria:
- Age less than 18 years
Locations and Contacts
Additional Information
Starting date: May 2010
Last updated: October 4, 2012
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