与中国西部局灶性癫痫患者首次使用抗癫痫药物相关的社会人口学因素。
Sociodemographic factors associated with the first administration of anti-seizure medication in patients with focal epilepsy in Western China.
机构信息
Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
出版信息
BMC Neurol. 2021 Jun 29;21(1):251. doi: 10.1186/s12883-021-02282-w.
BACKGROUND
Epilepsy is a severe chronic neurologic disease with a prevalence of 0.7% worldwide; anti-seizure medications (ASMs) are the mainstay of epilepsy treatment. The effects of sociodemographic factors on the characteristics of initial treatment in patients with newly diagnosed focal epilepsy in Western China are unknown. This study was conducted to explore sociodemographic factors associated with initial treatment characteristics.
METHODS
Patients with focal epilepsy on continuous ASM treatment who visited to our epilepsy center at Sichuan Provincial People's Hospital between January 2018 and December 2019 were recruited. Data on initial treatment status and sociodemographic variables were obtained from the patients with a questionnaire designed by our researchers. We examined whether sociodemographic factors were associated with epileptic patients' access to neurologists and prescriptions of individual ASMs.
RESULTS
A total of 569 patients completed this study. We found that patients with a higher education level, aged < 16 years, and with a higher household disposable income were more likely to receive treatment from a neurologist than their counterparts. Patients with a lower personal income level and who were treated at a junior hospital were more likely to receive prescriptions for carbamazepine, and those who were younger than 16 years were less likely to receive prescriptions for carbamazepine and oxcarbazepine. Patients with a higher education level, with a higher household disposable income level, who were younger than 16 years, and who were treated at a senior hospital were more likely to receive prescriptions for levetiracetam than their counterparts. Adult, female patients with focal epilepsy treated at a senior hospital were more likely to receive prescriptions for lamotrigine.
CONCLUSIONS
This observation suggests that sociodemographic characteristics are associated with access to neurologists and prescriptions of individual antiepileptic drugs. These data may help public health officials establish guidelines for doctors and distribute resources according to the needs of different patient groups.
背景
癫痫是一种严重的慢性神经系统疾病，全球患病率为 0.7%；抗癫痫药物（ASM）是癫痫治疗的主要手段。社会人口因素对中国西部新诊断局灶性癫痫患者初始治疗特征的影响尚不清楚。本研究旨在探讨与初始治疗特征相关的社会人口因素。
方法
本研究纳入了 2018 年 1 月至 2019 年 12 月期间在四川省人民医院癫痫中心接受连续 ASM 治疗的局灶性癫痫患者。通过我们的研究人员设计的问卷，获得了患者初始治疗状况和社会人口学变量的数据。我们研究了社会人口因素是否与癫痫患者获得神经科医生治疗和特定 ASM 处方有关。
结果
共有 569 名患者完成了本研究。我们发现，文化程度较高、年龄<16 岁、家庭可支配收入较高的患者更有可能接受神经科医生的治疗。个人收入较低、在基层医院就诊的患者更有可能接受卡马西平治疗，而年龄<16 岁的患者则不太可能接受卡马西平和奥卡西平治疗。文化程度较高、家庭可支配收入较高、年龄<16 岁、在高级医院就诊的患者更有可能接受左乙拉西坦治疗。年龄较大、女性、在高级医院就诊的局灶性癫痫患者更有可能接受拉莫三嗪治疗。
结论
这些观察结果表明，社会人口学特征与获得神经科医生治疗和特定抗癫痫药物的处方有关。这些数据可能有助于公共卫生官员根据不同患者群体的需求为医生制定指导方针并分配资源。
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