COMMENTARY

Updating Epilepsy Epidemiology Statistics

Andrew N. Wilner, MD; Sandra L. Helmers, MD, MPH

Disclosures

February 06, 2015

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Andrew N. Wilner, MD: Hi. This is Dr Andrew Wilner, reporting for Medscape. I am pleased to be speaking with Dr Sandra Helmers, who is professor of neurology and pediatrics at Emory University School of Medicine in Atlanta, Georgia. Dr Helmers has been working on updating the epidemiology of epilepsy in the United States. She reported her study in a poster[1] at the most recent American Epilepsy Society (AES) Meeting in December 2014. Dr Helmers, tell us what you found.

Sandra L. Helmers, MD, MPH: We found that the prevalence of epilepsy is about 8.4 people with epilepsy per 1000, similar to what has been reported previously, but our incidence was a bit higher than reported by older epidemiologic studies. How did we reach our conclusions about incidence and prevalence? We used a large claims dataset from over 5 years of continuously insured people; the database included commercial insurance, Medicare Advantage, and Medicaid claims from 13 states, for a total of about 23 million lives. We applied the case definition for epilepsy to find the incidence and the prevalence.

As mentioned, the prevalence was within the range of what traditional epidemiology studies have shown in the past. However, that data are quite dated and are not as representative as what we found. Our study is the largest study in the United States and is more representative despite using claims data, which does have some limitations.

Dr Wilner: You found a prevalence of about 8 per 1000—so just under 1%.

Dr Helmers: Correct.

Dr Wilner: What was the incidence?

Dr Helmers: The incidence depended on age, but the overall age-adjusted incidence estimate for 2011 was 79.1 per 100,000 population, which is a bit higher than the usual epidemiology studies that have come out in the past.

Dr Wilner: Why should we care about epilepsy prevalence or incidence?

Dr Helmers: That is an excellent question. First, it is important to know how common a disorder or disease is so you can figure out how best to deliver care and how to define the best quality care. Many public health issues are involved with delivery of quality care. Having real world, up-to-date information is also important because healthcare resources are limited these days. People with epilepsy deserve access to what they need, and this is a way to facilitate that.

Dr Wilner: Who were your collaborators on this study?

Dr Helmers: We conducted the study in a unique collaboration involving the health outcomes and economic people at UCB Pharma and Dr Ed Faught and Dr David Thurman, my colleagues at Emory. It is unique because most pharmaceutical companies collaborate with academics on drug discovery rather than epidemiology. This was unique.

Dr Wilner: Do you have a plan for next year's AES meeting? Is there something in the works we should know about?

Dr Helmers: Several things are in the works. We are continuing to look at how people with epilepsy "show" themselves, as far as who is controlled or not controlled. What are the types of care that people with epilepsy get across the United States? We are interested in public health and health outcomes aspects of epilepsy. A better understanding of these is sorely needed, as outlined in the Institute of Medicine's report[2] in 2012.

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