AES: More Rxs for opioid painkillers held by epilepsy patients than by general population

December 11, 2014

Formulary managers should be alert to the use of opioid painkillers by special populations, such as people with epilepsy, according to findings during a poster session at the American Epilepsy Society annual meeting in Seattle.

Dr Wilner

Formulary managers should be alert to the use of opioid painkillers by special populations, such as people with epilepsy, according to findings during a poster session at the American Epilepsy Society annual meeting in Seattle.

Andrew Wilner, MD, of Angels Neurological Centers in Abington, Mass., and colleagues at Accordant Health Services examined healthcare claims data from 2012 of 10,271 people with epilepsy and compared them to 20,542 age, gender and insurance type matched controls. All of these patients participated in health plans in various parts of the United States. The researchers found that 26% of epilepsy patients had a prescription for a narcotic containing pain medication versus only 18% of people without epilepsy, which was a statistically significant difference (P<.001).

“Since epilepsy is, in and of itself, not a painful condition, we compared the prevalence of 16 pain conditions such as headache, abdominal pain, and joint pain in the epilepsy and control populations,” Dr Wilner explained. “All 16 pain conditions that we examined were significantly more common in the epilepsy population [P<.05].

“In our large study sample, people with epilepsy were more likely to have a prescription for a narcotic pain medication than controls,” Dr Wilner said. “Further research is needed to determine why people with epilepsy are more likely to use narcotic pain medications and are more likely to have pain conditions than a control population.” 

Knowledge of MATs can help overcome challenges of opioid abuse

When treating patients with epilepsy, or any chronic condition, one must also manage comorbid medical problems, according to Dr Wilner.

“In this study, we observed that epilepsy patients were more likely to use narcotics and have more pain conditions than people without epilepsy,” he said. “Caregivers must be aware of the increased likelihood of pain conditions in people with epilepsy and must also be alert to the possible complications of narcotic use, such as addiction, dependence, misuse, and overdose.”

In Dr Wilner’s and colleagues’ previous research on epilepsy and comorbidities published earlier this year in Epilepsy and Behavior, they found that the most commonly used drug class in the epilepsy population was antiepileptic medication, which was expected.

“However, we did not expect that the second most common drug class was narcotic containing opioids,” Dr Wilner said. “That inspired us to examine this observation further and led to this study.”