{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:03:29Z","timestamp":1790787809912,"version":"4.1.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Antiseizure medications are commonly prescribed for poststroke seizures, yet long\u2010term use lacks clear clinical guidance. We examined medication treatment patterns among older adults who initiated levetiracetam, the most frequently prescribed antiseizure medication, within 30\u2009days after an acute ischemic stroke discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed a national 20% random sample of US Medicare beneficiaries aged \u226565\u2009years, who were hospitalized for a first acute ischemic stroke between 2009 and 2021 and initiated levetiracetam within 30\u2009days of discharge. To analyze time\u2010varying Levetiracetam treatment patterns over the first year after initiation, we calculated an adjusted proportion of days covered that accounts for prescription overlap, hospitalization, and non\u2010persistence. Adherence to levetiracetam treatment strategy was defined as having a proportion of days covered \u226580%. A latent\u2010class mixed model on proportion of days covered trajectories was applied to identify and characterize different treatment patterns, adjusting for clinical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">In our sample of 1697 levetiracetam initiators, the mean age was 77.5\u2009years, and 58% were women. The latent\u2010class mixed model on proportion of days covered trajectories identified 3 distinct levetiracetam treatment patterns: (1) 907 patients (53%) were nonadherent to treatment after 2\u2009months, (2) 99 patients (6%) were nonadherent to treatment after 10\u2009months, and (3) 691 patients (41%) remained consistently adherent to treatment for at least 1\u2009year. White patients and women were more likely to be adherent to the levetiracetam treatment strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Approximately 41% of older adults remained consistently adherent to the levetiracetam treatment strategy within a year after outpatient initiation, with race and sex significantly associated with adherence\u2010to\u2010treatment probabilities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046583","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:07:01Z","timestamp":1775556421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment Patterns of Antiseizure Medication for Poststroke Prophylaxis Among Older Adults"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-9388","authenticated-orcid":false,"given":"Shuo","family":"Sun","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaella Caz\u00e9","family":"de Medeiros","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7624-2423","authenticated-orcid":false,"given":"Julianne D.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5837-3203","authenticated-orcid":false,"given":"Joseph P.","family":"Newhouse","sequence":"additional","affiliation":[{"name":"Harvard Medical School","place":["Boston, USA"]},{"name":"Harvard T. H. Chan School of Public Health","place":["Boston, USA"]},{"name":"Harvard Kennedy School","place":["Cambridge, USA"]},{"name":"National Bureau of Economic Research","place":["Cambridge, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-9145","authenticated-orcid":false,"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-0655","authenticated-orcid":false,"given":"Sebastien","family":"Haneuse","sequence":"additional","affiliation":[{"name":"Harvard T. H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-1315","authenticated-orcid":false,"given":"Lidia M. V. 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