Abstract Details

Title Intravenous Antiseizure Medication Utilization Patterns Among Seizure Patients Treated in US Hospitals: a Database Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 134

Objective Assess patterns of intravenous (IV) antiseizure medication (ASM) use among patients with seizures treated in US hospitals.

Background Seizure management in hospitals is complex due to diverse etiologies and comorbidities. Little is known about IV ASM use for seizure treatment in hospitals.

Design/Methods Using chargemaster data from 860 US hospitals in the Premier Healthcare Database, we analyzed adults with discharge diagnosis of seizure treated in the emergency department (ED) or inpatient (IP) setting from 01Jul2016–31Dec2019. Concomitant IV ASM use, formulation of injectable ASMs including benzodiazepines (BZD), and commonly used seizure treatment regimens were assessed by setting.

Results 1.36 million (52% IP, 48% ED) adult patients with seizures were analyzed. Most (88%) patients requiring injectable therapy were treated with a single ASM, with rates of single ASM use higher in the IP (98%) vs ED (85%) setting. Polytherapy use of injectable ASMs with non-consecutive (4.7%) or consecutive (7.0%) days of overlap was less common. Among monotherapy treated IV ASM patients in the IP setting with a length of stay ≥2 days, a step-down to the same oral dose ranged from 32%–59% (highest for lacosamide), step-down to another oral ASM ranged from 4%–18% (highest for brivaracetam), and no step-down to any oral ASM ranged from 34%–57% (highest for phenobarbital). Monotherapy treatment with an injectable ASM was more common than combination of injectable ASMs. One-third of patients in the IP setting used IV/intramuscular BZD compared to 9.6% in the ED setting.

Conclusions Concomitant use of injectable ASMs is uncommon among patients with seizures treated in US hospitals. A high percentage of patients receiving IV ASMs with no step-down to oral was observed, which may signal inappropriate post-discharge treatment. More research is needed to better understand why many IV ASMs were not stepped-down to an oral ASM prior to discharge.

Authors/Disclosures
Prashant Dongre, MD, MBBS (UCB Inc) PRESENTER	Dr. Dongre has received personal compensation for serving as an employee of UCB Inc. Dr. Dongre has stock in UCB Inc.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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Abstract Details