ANTIEPILEPTIC DRUG-USE IN NURSING-HOME RESIDENTS - EFFECT OF AGE, GENDER, AND COMEDICATION ON PATTERNS OF USE

Purpose: Examine antiepileptic drug (AED) use in nursing homes by age, gender, and use of comedication that can interact with AEDs. Methods: Two point-prevalence evaluations of AED use from computerized medical records of nursing home residents throughout the United States (set 1 , 43,757; set 2, 41,386) 65 years and older serviced by PHARMERICA. Re sults: 10.5% of residents received an AED. Of the age group 65-84 year s, 15% received an AED compared with 6.1% of those 85 years or older ( p < 0.001). Gender differences were present: 13.4% of the male residen ts and 9.4% of the female residents were treated with an AED (p < 0.00 1). The most frequently prescribed AEDs were phenytoin, carbamazepine, clonazepam, or phenobarbital. The average number of routine medicatio ns taken by AED recipients was 5.6, greater than the average of 4.6 fo r other residents. Conclusions: AEDs are extensively prescribed for el derly nursing home residents. Men and persons aged 65-85 years were mo re likely to receive AEDs than were women or those older than 85 years . AED recipients receive more routine medications than do other reside nts, including co-medications that alter hepatic metabolism and clinic al response. The reasons for age and gender differences are unclear an d require further study.