Ignite Creation Date:
2024-05-05 @ 11:49 AM
Last Modification Date:
2024-10-26 @ 9:14 AM
Study NCT ID:
NCT00144001
Status:
COMPLETED
Last Update Posted:
2015-04-07
First Post:
2005-08-31
Brief Title:
Factors Associated With in Suboptimal Prescribing for Older Patients With Epilepsy
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Appropriateness of Antiepileptic Drug Use for Older Veterans
Status:
COMPLETED
Status Verified Date:
2008-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TIGER
Brief Summary:
Nearly 2 of veterans 65 are actively treated for epilepsy and the incidence is projected to increase with the aging of our society Since commonly used antiepileptic drugs are considered suboptimal for older patients it is important to understand existing patterns of treatment for older veterans with epilepsy
Detailed Description:
OBJECTIVES
1 Identify patient provider and system factors predicting adoption of recommended AEDs for treatment of newly diagnosed older veterans FY00-04
2 Identify barriers to use of recommended AED in initial therapy for newly diagnosed older veterans with epilepsy
3 Assess and compare effectiveness of long-term use of various AED
METHODS
Using existing national VA outpatient inpatient and pharmacy databases in conjunction with Medicare inpatient and outpatient standard analytic files the 1999 National Health Survey of VA Enrollees American Hospital Association data and primary data collection we will identify the extent to which treatment for older veterans newly diagnosed with epilepsy changed between FY00-FY04 and identify predictors of change at the patient provider and system levels We will begin to identify barriers to use of recommended AED using structured interviews with primary care and general neurology providers in sites with high and low use of suboptimal AEDs in incident cases Finally we will compare hospitalizations emergency room visits and fall-related injuries including fractures for patients on different AED regimens
RESULTS
We have identified 72638 patients who are at least 66 years of age have a diagnosis of epilepsy in VA or Medicare files and who also received AEDs from the VA 9682 of of these are incident cases 41867 are chronic cases and 21089 have been defined as having unknown onset We found wide variations in prescribing an high rates of use of suboptimal AEDs 70 We identified sites with high and low use of suboptimal and new AEDs We have finalized provider interview protocols and are in the process of gaining approval at individual sites
IMPACT
The proposed study will enhance understanding of factors associated with adoption of clinical recommendations for newly diagnosed older patients with epilepsy begin to identify barriers to their adoption and assess outcomes of epilepsy patients on chronic AED therapy This study will provide the foundation on which to develop interventions to improve care and will improve the quality of care for older veterans diagnosed with epilepsy
1 Identify patient provider and system factors predicting adoption of recommended AEDs for treatment of newly diagnosed older veterans FY00-04
2 Identify barriers to use of recommended AED in initial therapy for newly diagnosed older veterans with epilepsy
3 Assess and compare effectiveness of long-term use of various AED
METHODS
Using existing national VA outpatient inpatient and pharmacy databases in conjunction with Medicare inpatient and outpatient standard analytic files the 1999 National Health Survey of VA Enrollees American Hospital Association data and primary data collection we will identify the extent to which treatment for older veterans newly diagnosed with epilepsy changed between FY00-FY04 and identify predictors of change at the patient provider and system levels We will begin to identify barriers to use of recommended AED using structured interviews with primary care and general neurology providers in sites with high and low use of suboptimal AEDs in incident cases Finally we will compare hospitalizations emergency room visits and fall-related injuries including fractures for patients on different AED regimens
RESULTS
We have identified 72638 patients who are at least 66 years of age have a diagnosis of epilepsy in VA or Medicare files and who also received AEDs from the VA 9682 of of these are incident cases 41867 are chronic cases and 21089 have been defined as having unknown onset We found wide variations in prescribing an high rates of use of suboptimal AEDs 70 We identified sites with high and low use of suboptimal and new AEDs We have finalized provider interview protocols and are in the process of gaining approval at individual sites
IMPACT
The proposed study will enhance understanding of factors associated with adoption of clinical recommendations for newly diagnosed older patients with epilepsy begin to identify barriers to their adoption and assess outcomes of epilepsy patients on chronic AED therapy This study will provide the foundation on which to develop interventions to improve care and will improve the quality of care for older veterans diagnosed with epilepsy
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None