This study evaluated trends in resource use and prescription patterns in patients with active epilepsy over a 10-year period at the same outpatient clinic of a German epilepsy center. We analyzed a cross-sectional patient sample of consecutive adults with active epilepsy over a 3-month period in 2013 and compared them with equally acquired data from the years 2003 and 2008. Using validated patient questionnaires, data on socioeconomic status, course of epilepsy, as well as direct and indirect costs were recorded. A total of 198 patients (mean age: 39.6±15.0years, 49.5% male) were enrolled and compared with our previous assessments in 2003 (n=101) and 2008 (n=151). In the 2013 cohort, 75.8% of the patients had focal epilepsy, and the majority were taking antiepileptic drugs (AEDs) (39.9% monotherapy, 59.1% polytherapy). We calculated epilepsy-specific costs of €3674 per three months per patient. Direct medical costs were mainly due to anticonvulsants (20.9% of total direct costs) and to hospitalization (20.8% of total direct costs). The proportion of enzyme-inducing anticonvulsants and 'old' AEDs decreased between 2003 and 2013. Indirect costs of €1795 in 2013 were mainly due to early retirement (55.0% of total indirect costs), unemployment (26.5%), and days off due to seizures (18.2%). In contrast to our previous findings from 2003 and 2008, our data show a stagnating cost increase with slightly reduced total costs and balanced direct and indirect costs in patients with active epilepsy. These findings are accompanied by an ongoing cost-neutral increase in the prescription of 'newer' and non-enzyme-inducing AEDs. However, the number and distribution of indirect cost components remained unchanged.

译文

这项研究评估了德国癫痫中心同一门诊10年内活动性癫痫患者的资源使用和处方模式的趋势。我们分析了2013年3个月内连续患有活动性癫痫的成年人的横断面患者样本,并将其与来自2003年和2008的同等获取数据进行了比较。使用经过验证的患者问卷,记录了有关社会经济状况,癫痫病程以及直接和间接费用的数据。总共纳入了198例患者 (平均年龄: 39.6 ± 15.0岁,49.5% 例男性),并与我们以前的评估2003年 (n = 101) 和2008 (n = 151) 进行了比较。在2013队列中,75.8% 的患者患有局灶性癫痫,大多数患者服用抗癫痫药 (aed) (39.9% 单药治疗,59.1% 多药治疗)。我们计算了每位患者每三个月3674欧元的癫痫特定费用。直接医疗费用主要是由于抗惊厥药 (占总直接费用的20.9%) 和住院费用 (占总直接费用的20.8%)。诱导酶的抗惊厥药和 “旧” aed的比例2003年和2013下降。2013年1795欧元的间接费用主要是由于提前退休 (占总间接费用的55.0%),失业 (26.5%) 和因癫痫发作而休假 (18.2%)。与2003年和2008之前的发现相反,我们的数据显示,活动性癫痫患者的成本增长停滞,总成本略有降低,直接和间接成本平衡。这些发现伴随着 “新” 和非酶诱导aed处方的成本中性增加。但是,间接成本组成部分的数量和分布保持不变。

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