{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T22:31:26Z","timestamp":1781476286910,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the trends in antiseizure medications (ASMs) use following ischemic stroke and to examine factors associated with use of newer\u2010 and older\u2010generation ASMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted using state\u2010wide linked health datasets. Patients who were hospitalized with a first\u2010ever ischemic stroke between 2013 and 2017 and were dispensed ASM within 12\u2009months from discharge were included. Logistic regression was used to examine the predictors of receiving newer\u2010generation ASMs. Generalized linear modeling was used to identify factors associated with ASM use after ischemic stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 19\u2009601 people hospitalized with a first\u2010ever ischemic stroke, 989 were dispensed an ASM within 12\u2009months from discharge. The most prevalent first ASMs were levetiracetam (38.0%), valproate (25.8%), and carbamazepine (10.3%). Most people were dispensed ASM monotherapy (86.9%). There was a shift toward the use of newer\u2010generation ASMs between 2013 and 2017 (odds ratio [OR] 2.82, 95% confidence interval [CI] 1.92\u20134.16). Metropolitan residents were more likely to be dispensed newer\u2010generation ASMs as a first\u2010line treatment (OR 1.79, 95% CI 1.31\u20132.45). People over 85\u2009years (OR 0.38, 95% CI 0.23\u20130.64), with dementia (OR 0.35, 95% CI 0.19\u20130.63) and psychotic comorbidities (OR 0.29, 95% CI 0.09\u20130.96) were less likely to be dispensed newer\u2010generation ASMs. Older age (coefficient [<jats:italic>\u03b2<\/jats:italic>] 0.23, <jats:italic>P<\/jats:italic>\u2009=\u20090.030), history of beta blocker use (<jats:italic>\u03b2<\/jats:italic> 0.17, <jats:italic>P<\/jats:italic>\u2009=\u20090.029), multiple ASMs (<jats:italic>\u03b2<\/jats:italic> 0.78, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and newer\u2010generation ASM (<jats:italic>\u03b2<\/jats:italic> 0.23, <jats:italic>P<\/jats:italic>\u2009=\u20090.001) were associated with higher defined daily dose (DDD) of ASM whereas female sex and being married were associated with lower DDD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>There has been a shift toward newer\u2010generation ASMs for poststroke seizures and epilepsy. Concerningly, vulnerable patient groups were more likely to be dispensed older\u2010generation ASMs. This may lead to unnecessary exposure to adverse events and drug\u2013drug interactions. Further research is needed to evaluate comparative effectiveness and safety of newer\u2010 and older\u2010generation ASMs in poststroke populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12809","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T03:44:08Z","timestamp":1691984648000},"page":"1413-1424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Shift from older\u2010 to newer\u2010generation antiseizure medications in people with acute ischemic stroke in Australia: A population\u2010based study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5052-1195","authenticated-orcid":false,"given":"Stella Jung\u2010Hyun","family":"Kim","sequence":"first","affiliation":[{"name":"Centre for Medicine Use and Safety Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9256-2216","authenticated-orcid":false,"given":"Stephen","family":"Wood","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-0374","authenticated-orcid":false,"given":"Clara","family":"Marquina","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8958-3844","authenticated-orcid":false,"given":"Emma","family":"Foster","sequence":"additional","affiliation":[{"name":"Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6115-2767","authenticated-orcid":false,"given":"J. Simon","family":"Bell","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-9441","authenticated-orcid":false,"given":"Jenni","family":"Ilom\u00e4ki","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety Monash University  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318296aeca"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42494-021-00068-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13813"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1179\/1074935715Z.00000000062"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2014.09.030"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000512972"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987317705536"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2018-000175"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12766"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.11.013"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13617"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.800524"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2330"},{"key":"e_1_2_12_16_1","unstructured":"Independent Health and Aged Care Pricing Authority.ICD\u201010\u2010AM\/ACHI\/ACS.2023[cited 2023 May 4].https:\/\/www.ihacpa.gov.au\/health\u2010care\/classification\/icd\u201010\u2010amachiacs"},{"key":"e_1_2_12_17_1","unstructured":"The Pharmaceutical Benefits Scheme.Australian statistics on medicines.2015[cited 2023 May 4].https:\/\/www.pbs.gov.au\/info\/statistics\/asm\/asm\u20102015"},{"key":"e_1_2_12_18_1","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology.ATC\/DDD index.2023[cited 2023 May 4]."},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098611411127"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03024.x"},{"key":"e_1_2_12_21_1","unstructured":"World Health Organization.Defined daily dose (DDD).2023[cited 2023 May 4].https:\/\/www.who.int\/tools\/atc\u2010ddd\u2010toolkit\/about\u2010ddd#:~:text=To%20address%20this%2C%20a%20technical its%20main%20indication%20in%20adults"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1871"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032551"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282x-anp-2020-0012"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004407"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-014-0187-x"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2021.10.020"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181cbcd5c"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02282-w"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200101"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2020.106297"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-47"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3109\/10401230309085675"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrl.2014.09.005"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02529.x"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2020.16.4.556"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13234"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.108450"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-023-00637-3"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-022-02842-8"},{"key":"e_1_2_12_41_1","unstructured":"Australian Institute of Health and Welfare.Heart stroke and vascular disease: Australian facts.2023. 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