Utilization of antiepileptic drugs in Hong Kong children

Abstract

This study investigated the prescribing patterns of antiepileptic drugs, especially the uptake of newer drugs, among children and adolescents in Hong Kong. Data were retrieved from the Clinical Data Analysis and Reporting System. Children aged 0-19 years who received at least one prescription of anticonvulsants were selected. The study period extended from April 1, 2005 to March 31, 2009. The overall prevalence of anticonvulsants prescribing was 2.23/1000 children in 2005. A slight but steady decline in anticonvulsants prevalence was observed throughout the study period. Valproic acid was the most frequently prescribed drug, followed by carbamazepine and benzodiazepine derivatives. The use of newer anticonvulsants rose significantly, by 26.9%. The use of valproic acid remained unchanged, whereas the use of carbamazepine declined by 20%. Among newer drugs, the use of levetiracetam increased fourfold, and that of oxcarbazepine increased 15-fold. In the youngest age group, phenobarbital was the second most frequently used drug. A significant increase in lamotrigine prescriptions was not observed among adolescents. The persistent increase in using newer antiepileptic drugs implies not only an increase in drug expenditure. It also reflects the need to assess cost-effectiveness in terms of long-term outcomes, quality of life, and health economic outcomes.