Rates of Comorbid Conditions in Epilepsy Are High and Reflect Health Care Disparities

In a novel study of Medicaid data using machine learning techniques, rates of comorbid conditions in people with epilepsy were higher than in the general population. Additionally, people with epilepsy who have Medicaid coverage are more likely to have these comorbid conditions when compared with those who have private insurance. Higher rates of these conditions were also observed in Black and Hispanic/Latinx people when compared with white people. 

“Our data-driven approach identified previously unknown combinations of conditions in Medicaid recipients with epilepsy, reflecting the complexity of real life for these patients,” said Wyatt Bensken, BS, lead author of the study and a doctoral candidate in epidemiology and biostatistics at Case Western Reserve University in Cleveland.

Among the 18,963 people with epilepsy whose health records were evaluated, 

• 46.5% had anxiety and mood disorders (20% higher than in general population)
• 36.9% had hypertension (7% higher than in general population)
• 35.2% had back problems
• 31.6% had developmental delays or learning disabilities
• 29.5% had headache including migraine

Among 9.1%, a combination of anxiety and mood disorders, injuries, back problems, and headache occurred. Prevalence of anxiety and mood disorders was higher for those on Medicaid vs private insurance (46.5% vs 20%-40%) as was hypertension (36.9% vs 12%-25%).  Among Black persons with epilepsy, 52.7% had hypertension compared with 33.3% of white persons. Black people and Native American and Alaskan natives were more likely to have 3 or more comorbidities.  

“It is critically important to recognize that epilepsy does not occur in isolation,” said Siran Koroukian, PhD, senior author and professor of population and quantitative health sciences at Case Western Reserve University. “Our study shows it’s vital for people with epilepsy to be treated by a multidisciplinary team to address all of the patients’ health issues, which can help improve their epilepsy care, outcomes and quality of life.”

These data were presented at the American Epilepsy Society (AES) Annual Meeting, held December 3-7, 2021 in Chicago, Illinois and virtually through AES 2021 Digital Select.