Key Takeaways:
- Prescribing a 90-day supply of antiseizure medications (ASMs) improved adherence among veterans with epilepsy compared to a 30-day supply.
- Better adherence resulted in fewer breakthrough seizures and emergency department (ED) visits.
- Findings led to a policy change at one VA location, with another location considering adoption.
Summary
U.S. veterans with epilepsy who received a 90-day supply of ASMs were more likely to adhere to their medication regimen than those receiving a 30-day supply, leading to fewer missed doses, breakthrough seizures, and seizure-related injuries. These results have prompted policy changes within the Veterans Affairs (VA) system to improve access to medications.
Study Details:
- The study, conducted by Rebekah Kaska, MSN, and colleagues from the VA Epilepsy Center of Excellence in Richmond, Virginia, analyzed data from 708 veterans treated at VA Epilepsy Centers in Richmond (n = 308), Houston (n = 252), and Los Angeles (n = 148).
- Researchers compared adherence rates, breakthrough seizures, ED admissions, and other outcomes between patients receiving 30-day vs. 90-day prescriptions.
Findings:
- Adherence Rates:
- Average proportion of days covered with ASMs was 85%-87% for the 30-day supply and 93% for the 90-day supply.
- Missed Days:
- Patients with a 30-day supply missed 48-56 days of medication annually, compared to 25-26 days missed by those with a 90-day supply.
- Health Outcomes:
- Veterans with a 90-day supply experienced fewer breakthrough seizures, ED visits, and seizure-related injuries.
Impact:
- The findings influenced a policy change at the Richmond VA location, allowing certain ASMs to be prescribed in 90-day supplies with one refill.
- The Houston VA is developing a similar policy, while the Los Angeles VA already demonstrates a 96% adherence rate for controlled ASMs.
Implications:
Kaska emphasized the importance of improving adherence to ASMs, noting that delayed or missed doses can have severe consequences, including death. The policy shift is expected to enhance patient safety and quality of life.
This research was presented at the 2024 American Epilepsy Society annual meeting.
