RT Journal Article SR Electronic T1 Racial and Ethnic Differences in Antiseizure Medications Among People With Epilepsy on Medicaid JF Neurology: Clinical Practice FD Lippincott Williams & Wilkins SP e200101 DO 10.1212/CPJ.0000000000200101 VO 13 IS 1 A1 Wyatt P. Bensken A1 Guadalupe Fernandez Baca Vaca A1 Philip M. Alberti A1 Omar I. Khan A1 Timothy H. Ciesielski A1 Barbara C. Jobst A1 Scott M. Williams A1 Kurt C. Stange A1 Martha Sajatovic A1 Siran M. Koroukian YR 2023 UL http://cp.neurology.org/content/13/1/e200101.abstract AB Background and Objectives Being on a newer, second-, and third-generation antiseizure medication (ASM) may represent an important marker of quality of care for people with epilepsy. We sought to examine whether there were racial/ethnic differences in their use.Methods Using Medicaid claims data, we identified the type and number of ASMs, as well as the adherence, for people with epilepsy over a 5-year period (2010–2014). We used multilevel logistic regression models to examine the association between newer-generation ASMs and adherence. We then examined whether there were racial/ethnic differences in ASM use in models adjusted for demographics, utilization, year, and comorbidities.Results Among 78,534 adults with epilepsy, 17,729 were Black, and 9,376 were Hispanic. Overall, 25.6% were on older ASMs, and being solely on second-generation ASMs during the study period was associated with better adherence (adjusted odds ratio: 1.17, 95% confidence interval [CI]: 1.11–1.23). Those who saw a neurologist (3.26, 95% CI: 3.13–3.41) or who were newly diagnosed (1.29, 95% CI: 1.16–1.42) had higher odds of being on newer ASMs. Importantly, Black (0.71, 95% CI: 0.68–0.75), Hispanic (0.93, 95% CI: 0.88–0.99), and Native Hawaiian and Other Pacific Island individuals (0.77, 95% CI: 0.67–0.88) had lower odds of being on newer ASMs when compared with White individuals.Discussion Generally, racial and ethnic minoritized people with epilepsy have lower odds of being on newer-generation ASMs. Greater adherence by people who were only on newer ASMs, their greater use among people seeing a neurologist, and the opportunity of a new diagnosis point to actionable leverage points for reducing inequities in epilepsy care.