Abstract：
Uncontrolled seizures among people with epilepsy increase risk of adverse health and social outcomes including increased risk of death. Previous population-based studies have reported suboptimal seizure control and disparities in seizure control among U.S. adults with active epilepsy (self-reported doctor-diagnosed epilepsy and taking anti-seizure medicine or with ≥ 1 seizures in the past 12 months) by annual family income. This brief is based upon data from the 2021 and 2022 National Health Interview Survey (NHIS) to provide updated national estimates of the percentages of adults with active epilepsy with and without seizure control (0 seizures in past 12 months) vs. ≥ 1) by anti-seizure medication use and by annual family income. Annual family income was operationalized with NHIS poverty-income ratio (PIR) categories (i.e., total family income divided by the US Census Bureau poverty threshold given the family\'s size and number of children): PIR < 1.0, 1.0 ≤ PIR < 2.0; PIR ≥ 2.0. Among the 1.1 % of US adults with active epilepsy in 2021/2022 (estimated population about 2.9 million), 49.2 % (∼1.4 million) were taking antiseizure medication and reported no seizures (seizure control), 36.2 % (∼1.1 million) were taking antiseizure medication and reported ≥ 1 seizures (uncontrolled seizures), and 14.7 % (∼400,000) were not taking antiseizure medication and had ≥ 1 seizures (uncontrolled seizures). The prevalence of seizure control among those with active epilepsy varied substantially by annual family income, with a larger percentage of adults with PIR ≥ 2.0 reporting seizure control compared with those with PIR < 1.0. Opportunities for intervention include improving provider awareness of epilepsy treatment guidelines, enhancing access and referral to specialty care, providing epilepsy self-management supports, and addressing unmet social needs of people with epilepsy with uncontrolled seizures, especially those at lowest family income levels.
摘要：
癫痫患者不受控制的癫痫发作会增加不良健康和社会结果的风险，包括死亡风险增加。先前的基于人群的研究报告，按家庭年收入计算，美国成人活动性癫痫（自我报告为医生诊断的癫痫并服用抗癫痫药或在过去12个月内癫痫发作≥1次）的癫痫发作控制欠佳和癫痫发作控制差异。本简介基于2021年和2022年国家健康访谈调查（NHIS）的数据，提供了对有和没有癫痫发作控制的活动性癫痫成年人百分比的最新国家估计（过去12个月内有0次癫痫发作）与≥1）按抗癫痫药物使用和家庭年收入计算。家庭年收入采用NHIS贫困收入比(PIR)类别(即，考虑到家庭的规模和子女数量，家庭总收入除以美国人口普查局的贫困阈值）：PIR<1.0，1.0≤PIR<2.0；PIR≥2.0。在2021/2022年1.1%的美国成年人患有活动性癫痫（估计人口约290万）中，49.2%(约140万)的人服用抗癫痫药物，报告没有癫痫发作(癫痫发作控制)，36.2%(约110万)的人服用抗癫痫药物，报告癫痫发作≥1次(未控制的癫痫发作)，14.7%(~400,000)没有服用抗癫痫药物，癫痫发作≥1次(未控制的癫痫发作)。在活动性癫痫患者中，癫痫发作控制的患病率因家庭年收入而异。与PIR<1.0的成年人相比，PIR≥2.0的成年人报告癫痫发作得到控制的比例更高。干预的机会包括提高提供者对癫痫治疗指南的认识，加强专科护理的获取和转诊，提供癫痫自我管理支持，并解决癫痫患者未得到满足的社会需求，尤其是那些收入最低的家庭。
