Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions

Rachel Charlton; Ester Garne; Hao Wang; Kari Klungsøyr; Sue Jordan; Amanda Neville; Anna Pierini; Anne Hansen; Anders Engeland; Rosa Gini; Daniel Thayer; Jens Bos; Aurora Puccini; Anne-Marie Nybo Andersen; Helen Dolk; Lolkje de Jong-van den Berg

doi:10.1002/pds.3847

Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions

Rachel Charlton, Ester Garne, Hao Wang, Kari Klungsøyr, Sue Jordan, Amanda Neville, Anna Pierini, Anne Hansen, Anders Engeland, Rosa Gini, Daniel Thayer, Jens Bos, Aurora Puccini, Anne-Marie Nybo Andersen, Helen Dolk, Lolkje de Jong-van den Berg

https://www.ifsv.ku.dk/om-instituttet/socialmedicin/

22 Citationer (Scopus)

Abstract

Purpose

The aim of this study was to explore antiepileptic drug (AED) prescribing before, during and after pregnancy as recorded in seven population-based electronic healthcare databases.

Methods

Databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the Clinical Practice Research Datalink, representing the rest of the UK, were accessed for the study. Women with a pregnancy starting and ending between 2004 and 2010, which ended in a delivery, were identified. AED prescriptions issued (UK) or dispensed (non-UK) at any time during pregnancy and the 6 months before and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated.

Results

In total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy and was lowest during the third trimester, before returning to pre-pregnancy levels by 6 months following delivery. For all deliveries, the prevalence of AED prescribing during pregnancy was 51 per 10 000 pregnancies (CI₉₅49–52%) and was lowest in the Netherlands (43/10 000; CI₉₅33–54%) and highest in Wales (60/10 000; CI₉₅54–66%). In Denmark, Norway and the two UK databases lamotrigine was the most commonly prescribed AED; whereas in the Italian and Dutch databases, carbamazepine, valproate and phenobarbital were most frequently prescribed. Few women prescribed with AEDs in the 3 months before pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI₉₅0.3–1.8%) in Emilia Romagna to 33.5% (CI₉₅28.7–38.4%) in Wales.

Conclusion

The country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care.

Originalsprog	Engelsk
Tidsskrift	Pharmacoepidemiology and Drug Safety
Vol/bind	24
Udgave nummer	11
Sider (fra-til)	1144-1154
Antal sider	11
ISSN	1053-8569
DOI	https://doi.org/10.1002/pds.3847
Status	Udgivet - 1 nov. 2015

Adgang til dokumentet

10.1002/pds.3847

Citationsformater

Charlton, R., Garne, E., Wang, H., Klungsøyr, K., Jordan, S., Neville, A., Pierini, A., Hansen, A., Engeland, A., Gini, R., Thayer, D., Bos, J., Puccini, A., Nybo Andersen, A-M., Dolk, H., & de Jong-van den Berg, L. (2015). Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions. Pharmacoepidemiology and Drug Safety, 24(11), 1144-1154. https://doi.org/10.1002/pds.3847

Charlton, R, Garne, E, Wang, H, Klungsøyr, K, Jordan, S, Neville, A, Pierini, A, Hansen, A, Engeland, A, Gini, R, Thayer, D, Bos, J, Puccini, A, Nybo Andersen, A-M, Dolk, H & de Jong-van den Berg, L 2015, 'Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions', Pharmacoepidemiology and Drug Safety, bind 24, nr. 11, s. 1144-1154. https://doi.org/10.1002/pds.3847

@article{8661b2adc4664d94a73fa544086c0325,

title = "Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions",

abstract = "PurposeThe aim of this study was to explore antiepileptic drug (AED) prescribing before, during and after pregnancy as recorded in seven population-based electronic healthcare databases.MethodsDatabases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the Clinical Practice Research Datalink, representing the rest of the UK, were accessed for the study. Women with a pregnancy starting and ending between 2004 and 2010, which ended in a delivery, were identified. AED prescriptions issued (UK) or dispensed (non-UK) at any time during pregnancy and the 6 months before and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated.ResultsIn total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy and was lowest during the third trimester, before returning to pre-pregnancy levels by 6 months following delivery. For all deliveries, the prevalence of AED prescribing during pregnancy was 51 per 10 000 pregnancies (CI9549–52%) and was lowest in the Netherlands (43/10 000; CI9533–54%) and highest in Wales (60/10 000; CI9554–66%). In Denmark, Norway and the two UK databases lamotrigine was the most commonly prescribed AED; whereas in the Italian and Dutch databases, carbamazepine, valproate and phenobarbital were most frequently prescribed. Few women prescribed with AEDs in the 3 months before pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI950.3–1.8%) in Emilia Romagna to 33.5% (CI9528.7–38.4%) in Wales.ConclusionThe country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care.",

author = "Rachel Charlton and Ester Garne and Hao Wang and Kari Klungs{\o}yr and Sue Jordan and Amanda Neville and Anna Pierini and Anne Hansen and Anders Engeland and Rosa Gini and Daniel Thayer and Jens Bos and Aurora Puccini and {Nybo Andersen}, Anne-Marie and Helen Dolk and {de Jong-van den Berg}, Lolkje",

note = "Copyright {\textcopyright} 2015 John Wiley & Sons, Ltd.",

year = "2015",

month = nov,

day = "1",

doi = "10.1002/pds.3847",

language = "English",

volume = "24",

pages = "1144--1154",

journal = "Pharmacoepidemiology and Drug Safety",

issn = "1053-8569",

publisher = "JohnWiley & Sons Ltd",

number = "11",

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TY - JOUR

T1 - Antiepileptic drug prescribing before, during and after pregnancy

T2 - a study in seven European regions

AU - Charlton, Rachel

AU - Garne, Ester

AU - Wang, Hao

AU - Klungsøyr, Kari

AU - Jordan, Sue

AU - Neville, Amanda

AU - Pierini, Anna

AU - Hansen, Anne

AU - Engeland, Anders

AU - Gini, Rosa

AU - Thayer, Daniel

AU - Bos, Jens

AU - Puccini, Aurora

AU - Nybo Andersen, Anne-Marie

AU - Dolk, Helen

AU - de Jong-van den Berg, Lolkje

PY - 2015/11/1

Y1 - 2015/11/1

N2 - PurposeThe aim of this study was to explore antiepileptic drug (AED) prescribing before, during and after pregnancy as recorded in seven population-based electronic healthcare databases.MethodsDatabases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the Clinical Practice Research Datalink, representing the rest of the UK, were accessed for the study. Women with a pregnancy starting and ending between 2004 and 2010, which ended in a delivery, were identified. AED prescriptions issued (UK) or dispensed (non-UK) at any time during pregnancy and the 6 months before and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated.ResultsIn total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy and was lowest during the third trimester, before returning to pre-pregnancy levels by 6 months following delivery. For all deliveries, the prevalence of AED prescribing during pregnancy was 51 per 10 000 pregnancies (CI9549–52%) and was lowest in the Netherlands (43/10 000; CI9533–54%) and highest in Wales (60/10 000; CI9554–66%). In Denmark, Norway and the two UK databases lamotrigine was the most commonly prescribed AED; whereas in the Italian and Dutch databases, carbamazepine, valproate and phenobarbital were most frequently prescribed. Few women prescribed with AEDs in the 3 months before pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI950.3–1.8%) in Emilia Romagna to 33.5% (CI9528.7–38.4%) in Wales.ConclusionThe country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care.

AB - PurposeThe aim of this study was to explore antiepileptic drug (AED) prescribing before, during and after pregnancy as recorded in seven population-based electronic healthcare databases.MethodsDatabases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the Clinical Practice Research Datalink, representing the rest of the UK, were accessed for the study. Women with a pregnancy starting and ending between 2004 and 2010, which ended in a delivery, were identified. AED prescriptions issued (UK) or dispensed (non-UK) at any time during pregnancy and the 6 months before and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated.ResultsIn total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy and was lowest during the third trimester, before returning to pre-pregnancy levels by 6 months following delivery. For all deliveries, the prevalence of AED prescribing during pregnancy was 51 per 10 000 pregnancies (CI9549–52%) and was lowest in the Netherlands (43/10 000; CI9533–54%) and highest in Wales (60/10 000; CI9554–66%). In Denmark, Norway and the two UK databases lamotrigine was the most commonly prescribed AED; whereas in the Italian and Dutch databases, carbamazepine, valproate and phenobarbital were most frequently prescribed. Few women prescribed with AEDs in the 3 months before pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI950.3–1.8%) in Emilia Romagna to 33.5% (CI9528.7–38.4%) in Wales.ConclusionThe country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care.

U2 - 10.1002/pds.3847

DO - 10.1002/pds.3847

M3 - Journal article

C2 - 26272314

SN - 1053-8569

VL - 24

SP - 1144

EP - 1154

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

IS - 11

ER -

Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions

Abstract

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