Health risk factors and polypharmacy in people with epilepsy and their association with multimorbidity: a single...

The drivers of chronic disease in people with epilepsy with epilepsy (PWE) are unknown. We aimed to identify the role of health risk factors, polypharmacy, and medication usage in (PWE) according to age, sex, epilepsy types, epilepsy duration and resistance to treatment and their relevance to multimorbidity in epilepsy.

We analysed patient data from 330 PWE seen in a tertiary centre epilepsy clinic in Perth, Western Australia. The prevalence of biomedical and behavioural health risk factors (including hypertension, obesity or alcohol excess), polypharmacy, antiseizure (ASM) and general medication usage and their association with multimorbidity was investigated, as well as differences that existed across different age groups, sex, epilepsy types, epilepsy duration and resistance to treatment.

Participants who had ≥1 health risk factor (37 % of participants) had a significantly greater number of comorbidities (p = 0.0008). The number of ASMs and general medications used were positively correlated with the number of comorbidities (p's < 0.0001). Health risk factors were more commonly present in men (p = 0.0023), at older age (p < 0.0001) and in those with structural epilepsy (p = 0.0002). Polypharmacy was seen in 33 % of participants and was more commonly present in those of older age (p = 0.0003), in developmental and/or epileptic encephalopathy (DEE) (p = 0.0002) and in those with drug-resistant epilepsy (DRE) (p = 00006).

These findings indicate that health risk factors, polypharmacy and ASM usage are associated with chronic disease and multimorbidity in epilepsy. Routine screening and management of modifiable health risk factors and polypharmacy may reduce the chronic disease burden in PWE and its consequences.