biostudies-literatureTerman SWNCATS NIH HHSNIA NIH HHSNIH Office of the DirectorNIMHD NIH HHSNINDS NIH HHS2778-2789https://www.ebi.ac.uk/biostudies/studies/S-EPMC8563423biostudies-literatureUnknown62(11)<h4>Objective</h4>This study was undertaken to characterize trajectories of antiseizure medication (ASM) adherence in adults with newly treated epilepsy and to determine predictors of trajectories.<h4>Methods</h4>This was a retrospective cohort study using Medicare. We included beneficiaries with newly treated epilepsy (one or more ASM and none in the preceding 2 years, plus International Classification of Diseases codes) in 2010-2013. We calculated the proportion of days covered (proportion of total days with any ASM pill supply) for 8 quarters or until death. Group-based trajectory models characterized and determined predictors of trajectories.<h4>Results</h4>We included 24 923 beneficiaries. Models identified four groups: early adherent (60%), early nonadherent (18%), late adherent (11%), and late nonadherent (11%). Numerous predictors were associated with being in the early nonadherent versus early adherent group: non-White race (e.g., Black, odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.5-1.8), region (e.g., South vs. Northeast: OR = 1.2, 95% CI = 1.1-1.4), and once daily initial medication (OR = 1.1, 95% CI = 1.0-1.3). Predictors associated with decreased odds of being in the early nonadherent group included older age (OR = .9 per decade, 95% CI = .9-.9), female sex (OR = .9, 95% CI = .8-1.0), full Medicaid eligibility (OR = .6, 95% CI = .4-.8), neurologist visit (OR = .6, 95% CI = .6-.7), and initial older generation ASM (OR = .6, 95% CI = .6-.7).<h4>Significance</h4>We identified four ASM adherence trajectories in individuals with newly treated epilepsy. Whereas risk factors for early nonadherence such as race or geographic region are nonmodifiable, our work highlighted a modifiable risk factor for early nonadherence: lacking a neurologist. These data may guide future interventions aimed at improving ASM adherence, in terms of both timing and target populations.EpilepsiaAntiseizure medication adherence trajectories in Medicare beneficiaries with newly treated epilepsy.PMC8563423UL1 TR002240K76 AG059929R25 NS065723R01 MD008879T32 NS007222R25NS065723Terman SWBurke JFKerr WTMarcum ZAWang LfalseAntiseizure medication adherence trajectories in Medicare beneficiaries with newly treated epilepsy.<h4>Objective</h4>This study was undertaken to characterize trajectories of antiseizure medication (ASM) adherence in adults with newly treated epilepsy and to determine predictors of trajectories.<h4>Methods</h4>This was a retrospective cohort study using Medicare. We included beneficiaries with newly treated epilepsy (one or more ASM and none in the preceding 2 years, plus International Classification of Diseases codes) in 2010-2013. We calculated the proportion of days covered (proportion of total days with any ASM pill supply) for 8 quarters or until death. Group-based trajectory models characterized and determined predictors of trajectories.<h4>Results</h4>We included 24 923 beneficiaries. Models identified four groups: early adherent (60%), early nonadherent (18%), late adherent (11%), and late nonadherent (11%). Numerous predictors were associated with being in the early nonadherent versus early adherent group: non-White race (e.g., Black, odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.5-1.8), region (e.g., South vs. Northeast: OR = 1.2, 95% CI = 1.1-1.4), and once daily initial medication (OR = 1.1, 95% CI = 1.0-1.3). Predictors associated with decreased odds of being in the early nonadherent group included older age (OR = .9 per decade, 95% CI = .9-.9), female sex (OR = .9, 95% CI = .8-1.0), full Medicaid eligibility (OR = .6, 95% CI = .4-.8), neurologist visit (OR = .6, 95% CI = .6-.7), and initial older generation ASM (OR = .6, 95% CI = .6-.7).<h4>Significance</h4>We identified four ASM adherence trajectories in individuals with newly treated epilepsy. Whereas risk factors for early nonadherence such as race or geographic region are nonmodifiable, our work highlighted a modifiable risk factor for early nonadherence: lacking a neurologist. These data may guide future interventions aimed at improving ASM adherence, in terms of both timing and target populations.2021-01-01T00:00:00Z2021 Nov2025-04-03T22:45:19.1Z2025-02-19T01:30:50.761ZS-EPMC85634233446291110.1111/epi.17051