Abstracts

To examine the perceived impact of seizure versus selected medication adverse effects (AE) in patients with partial-onset epilepsy., A cross-sectional survey was conducted with 201 adult patients with partial-onset epilepsy receiving 2+ antiepileptic drugs (AEDs) and with 1+ seizure in the past year. Patients were asked to rate their health state by recording a number from 0 (worst) to 100 (best) based on their health today, hypothetical health if they were to experience a seizure today, and hypothetical health if they were to experience selected AEs today (incoordination, diplopia, dizziness, fatigue, weakness, headache, nausea, sleepiness, poor concentration, anomia). Decrements in health rating (HLTH) with a seizure today or an AE today were calculated as change from HLTH today. To contrast the relative impact of having a seizure to an AE, differences in decrements related to each AE (SZ-AE) were calculated. Higher positive SZ-AE values indicate a greater perceived decline in health status associated with experiencing a seizure; negative SZ-AE values indicate the AE negatively impacts health status more than a seizure does. Analyses were based on seizure frequency and recency., Overall health status ratings declined as seizure frequency increased [mean (SD) HLTH: once/6-12 months 76.2 (18), once/1-3 months 73.3 (20), 1+/week 65.6 (21); p =0.01]. Mean (SD) perceived decrements in HLTH with a seizure were greatest for patients with the least frequent seizures [once/6-12 months 37.3 (29), once/1-3 months 30.2 (27), 1+/week 21.2 (23); p=0.001]; as well as for seizure recency [last seizure 4+ months ago 36.8 (28), 1 week-3 months ago 33.5 (30), within the past week 21.4 (20); p=0.004]. Perceived decrements in HLTH associated with having a seizure compared to experiencing an AE (SZ-AE) differed significantly (p[lt]0.05 except for incoordination and weakness) across seizure recency groups. Among patients with last seizure 4+ months ago SZ-AE ratings were 10.1 [ndash] 27.0, implying perception of a new seizure was much worse than an AE; with last seizure 1 week-3 months ago SZ-AE ratings were 1.3 [ndash] 9.3, implying perception of seizure was somewhat worse than an AE; and with seizures within the past week SZ-AE ratings were -3.2 to -10.4, implying AE symptoms were more troublesome than seizures., Lack of seizure control is associated with decrements in health status. Patients perceived the effects of seizures and AEs differently. Patients with the least recent seizures may be most concerned with maintaining seizure control, while patients with more recent seizures are more sensitive to AED side effects, perhaps because their seizures remain uncontrolled. Our findings should help healthcare providers understand the risk-benefit concerns of patients when addressing the efficacy and AEs of AEDs., (Supported by Pfizer Inc.)