Department of Neurology, Epilepsy Center, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.
IQVIA, Epidemiology, Frankfurt am Main, Main Airport Center, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany.
Epilepsy Behav. 2021 Apr;117:107833. doi: 10.1016/j.yebeh.2021.107833. Epub 2021 Feb 19.
To gain insight into epilepsy care during coronavirus disease (COVID-19) pandemic, we analyzed prescription data of a large cohort of persons with epilepsy (PWE) during lockdown in Germany.
Information was obtained from the Disease Analyzer database, which collects anonymous demographic and medical data from practice computer systems of general practitioners (GP) and neurologists (NL) throughout Germany. We retrospectively compared prescription data for anti-seizure medication (ASM) and physicians' notes of "known" and "new" PWE from January 2020 until May 2020 with the corresponding months in the three preceding years 2017-2019. Adherence was estimated by calculating the proportion of patients with follow-up prescriptions within 90 days after initial prescriptions in January or February. We additionally analyzed hospital referrals of PWE. The significance level was set to 0.01 to adjust for multiple comparisons.
A total of 52,844 PWE were included. Anti-seizure medication prescriptions for known PWE increased in March 2020 (GP + 36%, NL + 29%; P < 0.01). By contrast, a decrease in prescriptions to known and new PWE was observed in April and significantly in May 2020 ranging from -16% to -29% (P < 0.01). The proportion of PWE receiving follow-up prescriptions was slightly higher in 2020 (73.5%) than in 2017-2019 (70.7%, P = 0.001). General practitioners and NL referred fewer PWE to hospitals in March 2020 (GP: -30%, P < 0.01; NL: -12%), April 2020 (GP: -29%, P < 0.01; NL: -37%), and May 2020 (GP: -24%, P < 0.01; NL: -16%).
Adherence of known PWE to ASM treatment appeared to remain stable during lockdown in Germany. However, this study revealed findings which point to reduced care for newly diagnosed PWE as well as fewer hospital admissions. These elements may warrant consideration during future lockdown situations.
了解冠状病毒病（COVID-19）大流行期间的癫痫护理情况，我们分析了德国封锁期间一大群癫痫患者（PWE）的处方数据。
信息来自疾病分析器数据库，该数据库从德国各地的全科医生（GP）和神经科医生（NL）的实践计算机系统中收集匿名人口统计学和医疗数据。我们回顾性地比较了 2020 年 1 月至 5 月与前三年（2017-2019 年）同期的抗癫痫药物（ASM）处方数据和“已知”和“新”PWE 的医生记录。通过计算初始处方后 90 天内随访处方的患者比例来估计依从性。我们还分析了 PWE 的住院转介情况。将显著性水平设为 0.01，以调整多重比较。
共纳入 52844 名 PWE。2020 年 3 月，已知 PWE 的抗癫痫药物处方增加（GP+36%，NL+29%；P<0.01）。相比之下，2020 年 4 月和 5 月，已知和新 PWE 的处方数量下降，幅度从-16%到-29%（P<0.01）。2020 年（73.5%）接受随访处方的 PWE 比例略高于 2017-2019 年（70.7%，P=0.001）。2020 年 3 月（GP：-30%，P<0.01；NL：-12%）和 4 月（GP：-29%，P<0.01；NL：-37%），GP 和 NL 转介给医院的 PWE 较少，5 月（GP：-24%，P<0.01；NL：-16%）。
德国封锁期间，已知 PWE 对 ASM 治疗的依从性似乎保持稳定。然而，本研究发现，新诊断的 PWE 的护理减少以及住院人数减少的情况。这些因素可能需要在未来的封锁期间考虑。
