Compared with white people, Latino, Black, Native Hawaiian and other Pacific Islander people with epilepsy are less likely to be prescribed newer drugs, according to a new study.
Published in Neurology Clinical Practice, the study also found that those who saw a neurologist were more than three times more likely to be prescribed newer drugs.
“While finding the right medication is often a trial-and-error process that is based on the individual, studies have shown that use of newer medications improves outcomes, and some newer medications have fewer side effects,” study author Wyatt Bensken, PhD, of Case Western Reserve University in Cleveland, said in an American Academy of Neurology press release. “These results show that a sizeable proportion of people may not be on an optimal treatment regimen, and the differences appear to reflect clear racial and ethnic inequities in care.”
Researchers looked at 78,534 adults with epilepsy who filled at least two prescriptions for epilepsy drugs from 2010 to 2014. Of this observed group, 17,729 people were Black, 9,376 were Latino and 1,154 were Native Hawaiian/Pacific Islander.
The researchers found that 26% of people were on older first-generation drugs, 65% were on second-generation drugs and 9% were on the newest third-generation drugs. Overall, 66% of white people were prescribed second-generation drugs compared with 64% of Black and Latino people and 56% of Native Hawaiian and other Pacific Islander people.
Third-generation drugs were prescribed to 11% of whites, 10% of Latinos and Native Hawaiians/Pacific Islanders and 6% of Blacks.
“While further study is needed to understand these differences and the mechanisms behind them, these critical gaps in care may represent disparities that can be addressed and that warrant greater attention,” Bensken said. “Changes that could be made include increasing referrals to neurologists and exploring whether a newer drug may be as effective as an older drug but with fewer side effects, which could increase the likelihood that people take all their doses.”