BACKGROUND: According to the Swedish Health Care Act, patients should be provided with the health care they need, regardless of sociodemographic status. We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in epilepsy. METHOD: Patients with epilepsy were identified in the National Patient Register. Persons >or=18 years on continuous AED treatment in 2006 were identified in the recently established Swedish Prescribed Drug Register. Data on sociodemographic variables were obtained from several other national registers. We linked data to examine whether epilepsy patients' access to neurologists and the prescription of individual AEDs are related to sex, age, educational level, area of residence, region of birth, or income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neurologists as compared to non-neurologists. RESULTS: We identified 26,124 epilepsy patients in the register who were on continuous AED treatment (effective sample). Being women, young, highly educated, having high incomes, and residing in a larger city meant being more often treated by a neurologist than by other specialists. The prescriptions of AEDs differed according to gender, age, education, place of residence, and income. Lamotrigine and levetiracetam were prescribed to a larger extent by a neurologist rather than by other specialists. CONCLUSIONS: This nationwide cross-sectional study of epilepsy patients indicates that sociodemographic characteristics are important for access to neurologists and prescriptions of individual antiepileptic drugs. Prospective studies using patient-related outcomes are needed to analyze the consequences of these differences.
BACKGROUND: According to the Swedish Health Care Act, patients should be provided with the health care they need, regardless of sociodemographic status. We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in epilepsy. METHOD:Patients with epilepsy were identified in the National Patient Register. Persons >or=18 years on continuous AED treatment in 2006 were identified in the recently established Swedish Prescribed Drug Register. Data on sociodemographic variables were obtained from several other national registers. We linked data to examine whether epilepsypatients' access to neurologists and the prescription of individual AEDs are related to sex, age, educational level, area of residence, region of birth, or income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neurologists as compared to non-neurologists. RESULTS: We identified 26,124 epilepsypatients in the register who were on continuous AED treatment (effective sample). Being women, young, highly educated, having high incomes, and residing in a larger city meant being more often treated by a neurologist than by other specialists. The prescriptions of AEDs differed according to gender, age, education, place of residence, and income. Lamotrigine and levetiracetam were prescribed to a larger extent by a neurologist rather than by other specialists. CONCLUSIONS: This nationwide cross-sectional study of epilepsypatients indicates that sociodemographic characteristics are important for access to neurologists and prescriptions of individual antiepileptic drugs. Prospective studies using patient-related outcomes are needed to analyze the consequences of these differences.
Authors: Isabell Brikell; Laura Ghirardi; Brian M D'Onofrio; David W Dunn; Catarina Almqvist; Søren Dalsgaard; Ralf Kuja-Halkola; Henrik Larsson Journal: Biol Psychiatry Date: 2017-08-12 Impact factor: 13.382
Authors: Heléne E K Sundelin; Zheng Chang; Henrik Larsson; Paul Lichtenstein; Catarina Almqvist; Torbjörn Tomson; Jonas F Ludvigsson Journal: Neurology Date: 2018-02-28 Impact factor: 9.910
Authors: Heléne E K Sundelin; Henrik Larsson; Paul Lichtenstein; Catarina Almqvist; Christina M Hultman; Torbjörn Tomson; Jonas F Ludvigsson Journal: Neurology Date: 2016-06-15 Impact factor: 9.910
Authors: Isabell Brikell; Qi Chen; Ralf Kuja-Halkola; Brian M D'Onofrio; Kelsey K Wiggs; Paul Lichtenstein; Catarina Almqvist; Patrick D Quinn; Zheng Chang; Henrik Larsson Journal: Epilepsia Date: 2019-01-25 Impact factor: 5.864