Table 4.
Predictors of Anticonvulsant Initiation Among Patients who Received a Psychotropic Medication and had no Obvious Indication for an Anticonvulsanta
| Regression Model Characteristics | ||||||
|---|---|---|---|---|---|---|
| Inclusion Criteria for Model | All (n=87,626) | Received Specific AC (n=5,532) | ||||
| Dependent Variable (Received Agent) | Any AC | Gabapentin | Valproic Acid | Lamotrigine | Topiramate | Carbamazepine |
| Prescription Status, % (n) | 6.31% (5,532) | 41.6% (2302) | 35.6% (1,969) | 12.0% (665) | 8.4% (465) | 3.7%(204) |
| Model Performance | c=0.74 | c=0.75 | c=0.72 | c=0.72 | c=0.67 | c=0.65 |
| Notation | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) |
| Patient Characteristics | ||||||
| Age >= 55 |
0.81 (0.76–0.86) |
2.21 (1.94–2.52) |
0.54 (0.48–0.62) |
0.84 (0.70–1.01) |
0.76 (0.61–0.94) |
0.90 (0.67–1.23) |
| Men |
1.20 (1.07–1.36) |
1.15 (0.87–1.51) |
2.79 (2.12–3.67) |
0.38 (0.29–0.50) |
0.31 (0.23–0.43) |
1.47 (0.75–2.87) |
| Psychotic Disorders (Non-Schizoaffective) |
0.81 (0.69–0.96) |
0.49 (0.33–0.71) |
1.55 (1.11–2.17) |
1.15 (0.72–1.83) |
0.91 (0.50–1.63) |
1.07 (0.50–2.25) |
| Unipolar Depressive Disorders | 1.02 (0.96–1.08) |
1.00 (0.88–1.13) |
0.77 (0.68–0.87) |
1.70 (1.41–2.06) |
1.03 (0.84–1.26) |
0.85 (0.63–1.15) |
| Anxiety Disorders | 0.96 (0.90–1.03) |
1.04 (0.90–1.20) |
1.03 (0.90–1.18) |
0.86 (0.71–1.05) |
1.02 (0.82–1.28) |
1.24 (0.90–1.71) |
| Personality Disorders |
1.53 (1.28–1.84) |
0.71 (0.47–1.05) |
1.64 (1.15–2.34) |
1.16 (0.73–1.84) |
0.69 (0.37–1.29) |
1.75 (0.90–3.41) |
| Non-Alcohol Substance Use Disorders |
0.91 (0.86–0.98) |
1.22 (1.06–1.41) |
0.99 (0.85–1.14) |
0.98 (0.80–1.19) |
0.73 (0.57–0.94) |
0.68 (0.47–0.98) |
| History of Traumatic Brain Injury |
1.35 (1.18–1.56) |
0.77 (0.57–1.05) |
1.38 (1.05–1.80) |
0.63 (0.41–0.97) |
2.27 (1.58–3.27) |
1.34 (0.73–2.45) |
| Service Use Characteristics | ||||||
| Fiscal Years 2008–2013 (v. 2004–2007) | 1.03 (0.97–1.09) |
1.49 (1.32–1.70) |
0.65 (0.57–0.73) |
1.71 (1.41–2.06) |
0.76 (0.62–0.93) |
0.65 (0.47–0.87) |
| 5–13 Mental Health Visits (v. 4 or fewer) |
1.41 (1.30–1.53) |
1.04 (0.87–1.24) |
1.06 (0.89–1.27) |
1.13 (0.87–1.49) |
1.88 (0.67–1.17) |
0.73 (0.49–1.07) |
| >= 14 Mental Health Visits (v. 4 or fewer) |
1.82 (1.66–1.98) |
1.25 (1.04–1.52) |
0.95 (0.78–1.15) |
1.41 (1.06–1.87) |
0.84 (0.62–1.14) |
0.60 (0.39–0.93) |
| One or More Inpatient Mental Health Admission |
1.70 (1.48–1.94) |
0.74 (0.56–0.99) |
1.12 (0.86–1.45) |
0.67 (0.46–1.00) |
0.81 (0.51–1.27) |
2.26 (1.39–3.68) |
| Three or More Psychiatric Medications (v. 1 or 2) |
6.15 (5.73–6.60) |
0.81 (0.69–0.96) |
1.12 (0.94–1.32) |
1.36 (1.06–1.74) |
1.37 (1.01–1.84) |
1.73 (1.12–2.68) |
| Any Recommended Medication for PTSD |
0.41 (0.38–0.44) |
1.22 (1.03–1.45) |
1.08 (0.91–1.28) |
0.51 (0.41–0.64) |
1.29 (0.96–1.73) |
0.73 (0.49–1.07) |
| Measures that Apply to AC Population Only | ||||||
| Plurality of AC Prescriptions from Mental Health | - |
0.24 (0.21–0.28) |
3.92 (3.29–4.67) |
3.69 (2.74–4.97) |
1.49 (1.13–1.96) |
1.36 (0.92–1.99) |
| Plurality of AC Prescriptions from Primary Care | - |
1.64 (1.34–2.02) |
0.70 (0.54–0.91) |
0.81 (0.52–1.28) |
0.66 (0.43–1.01) |
0.48 (0.25–0.94) |
a
Note. AC=Anticonvulsant, M=mean, SD=standard deviation, C=C-statistic
OR and 95% CI less than 1
OR and 95% CI greater than 1