{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:02:48Z","timestamp":1790787768747,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K08AG053380\u201001A1"],"award-info":[{"award-number":["1K08AG053380\u201001A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To examine indications for, duration of use, and rate of adverse drug events (ADE) attributable to anticonvulsant initiation, as adjudicated by expert review of electronic health records (EHR) of older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified a cohort of community dwelling Medicare beneficiaries with linked EHR (aged 65+, continuously enrolled with a large health system\/until death between 2012 and 2014, n = 20\u2009945) and drew a stratified EHR review sample (n = 1534). An expert reviewed all records to adjudicate anticonvulsant use, years of use, indication for use, and evidence of ADEs attributable to anticonvulsant initiation. After excluding patients with insufficient EHR data (n = 37; 2%), we reconstructed the cohort using inverse probability weights to resemble the original cohort of eligible beneficiaries (n = 20\u2009380). Among incident users of a single anticonvulsant, we estimated the rate of ADEs and described the type and severity of ADEs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 12% (n = 2469) of eligible beneficiaries used at least one anticonvulsant in the 2012 to 2014 period (4% [n = 757] incident users, 8% [n = 1712] prevalent users). Incident users were most frequently prescribed gabapentin (n = 461\/757, 61%), benzodiazepines (n = 122\/757, 16%), and levetiracetam (n = 74\/757, 10%); the most common indication was pain relief (n = 214; 28%) followed by epilepsy (n = 53; 7%). Among incident users, the overall ADE rate was 10\/100 person\u2010years (95% CI 4\u201020\/100 person\u2010years), of which 29% (n = 28\/97) were life threatening (eg, somnolence). Most ADEs among incident monotherapy users were nervous system related (68%, n = 66\/97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Many older adult community dwelling traditional Medicare beneficiaries had clinically significant ADEs likely attributable to the initiation of anticonvulsant therapy, which was begun for a range of indications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5139","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T05:54:37Z","timestamp":1601704477000},"page":"28-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Patterns of anticonvulsant use and adverse drug events in older adults"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-1315","authenticated-orcid":false,"given":"Lidia M. V. R.","family":"Moura","sequence":"first","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts"},{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-5849","authenticated-orcid":false,"given":"Jason R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyu","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Blacker","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts"},{"name":"Department of Psychiatry Massachusetts General Hospital  Boston Massachusetts"},{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Newhouse","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School  Boston Massachusetts"},{"name":"Department of Health Policy and Management Harvard T.H. Chan School of Public Health  Boston Massachusetts"},{"name":"Harvard Kennedy School  Cambridge Massachusetts"},{"name":"National Bureau of Economic Research  Cambridge Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1458-7642","authenticated-orcid":false,"given":"Sonia","family":"Hernandez\u2010Diaz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School  Boston Massachusetts"},{"name":"Mongan Institute, Department of Medicine Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"177 STAT. 2066. 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