{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:53:42Z","timestamp":1766159622967,"version":"3.46.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The proportion of patients with epilepsy who have a non\u2010intravenous rescue benzodiazepine (non\u2010IV\u2010rBZD) available for seizure emergencies is unknown. This study aims to describe prescription patterns from 2006 to 2022, factors associated with prescription, and the impact of recently introduced intranasal benzodiazepines on prescription and cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of the MarketScan Database, a claims database of privately insured patients in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 213\u2009384 patients (53% female, median (p\n                      <jats:sub>25<\/jats:sub>\n                      \u2010p\n                      <jats:sub>75<\/jats:sub>\n                      ) age: 33 (17\u201350) years) with epilepsy taking long\u2010term anti\u2010seizure medications with follow\u2010up of 2.62 (1.54\u20134.73) years, only 30\u2009371 patients (14.2%) had at least one non\u2010IV\u2010rBZD prescription. The proportion of patients with at least one non\u2010IV\u2010rBZD prescription was higher among: (1) younger patients (61.4% in the 0\u20135\u2009year age group, 44.2% in the 6\u201312\u2009year age group, 23.9% in the 13\u201321\u2009year age group, 4.8% in the 22\u201335\u2009year age group, 1.8% in the 36\u201350\u2009year age group, 1.3% in the 51\u201360 year age group, and 1.0% in the older than 60\u2009years age group); (2) patients with refractory epilepsy (24.3% vs 10.9% in non\u2010refractory epilepsy); and (3) patients with more emergency department visits or hospital admissions for epilepsy (7.1% among patients with 0, 19.2% among patients with 1\u20133, and 31.1% among patients with more than 3). Multivariate analysis confirmed young age, refractory epilepsy, and emergency department visits or hospitalizations for epilepsy as strong independent predictors of having at least one non\u2010IV\u2010rBZD prescription. Prescriptions for intranasal midazolam and intranasal diazepam have increased rapidly; they had moderately increased the overall proportion of patients with a non\u2010IV\u2010rBZD prescription, whereas the inflation\u2010adjusted cost of non\u2010IV\u2010rBZDs has markedly increased.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The vast majority of patients with epilepsy have not filled a prescription for non\u2010IV\u2010rBZDs. Seizure emergency readiness can be markedly improved, especially among adults. The cost of non\u2010IV\u2010rBZDs has increased with intranasal rescue medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18232","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T08:44:33Z","timestamp":1738399473000},"page":"648-661","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolution in the prescription and cost of non\u2010intravenous rescue benzodiazepines for the treatment of seizure emergencies"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4313-002X","authenticated-orcid":false,"given":"Iv\u00e1n","family":"S\u00e1nchez Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6887-3495","authenticated-orcid":false,"given":"Marta","family":"Amengual\u2010Gual","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Department of Pediatrics, Hospital Universitari Son Espases Universitat de les Illes Balears  Palma Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4719-6683","authenticated-orcid":false,"given":"Cristina","family":"Barcia Aguilar","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz Universidad Aut\u00f3noma de Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taha Fathima","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9175-9458","authenticated-orcid":false,"given":"Marina","family":"Ga\u00ednza\u2010Lein","sequence":"additional","affiliation":[{"name":"Instituto de Pediatr\u00eda, Facultad de Medicina Universidad Austral de Chile  Valdivia Chile"},{"name":"Facultad de Medicina Universidad de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alcy","family":"Torres","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Rinat","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie","family":"Douglass","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.5698\/1535-7597-16.1.48"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.1018"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0900-05.2005"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16984"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.4382"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15472"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005488"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13359"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2016.07.018"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-023-01359-3"},{"key":"e_1_2_13_12_1","unstructured":"Food and Drug Administration.Diastat (diazepam rectal gel). 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