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Valproate risk form-Surveying 215 clinicians involving 4775 encounters
Heather Angus-Leppan1,2, Melika M Moghim3, Hannah Cock4,5
1Epilepsy Initiative Group, Clinical Neurosciences, Royal Free London NHS Foundation Trust, London, UK.
Acta Neurologica Scandinavica
|February 20, 2020
Summary
Clinicians reported that 33%-43% of women experienced worsened seizure control after switching from valproate to other medications. This highlights the need for systematic data collection on valproate use and patient outcomes.
Area of Science:
- Neuroscience
- Pharmacology
- Public Health
Background:
- The Valproate Risk Acknowledgement Form (RAF) is mandatory in the UK to mitigate risks of in utero valproate exposure.
- Data on the number of women of childbearing potential on valproate, RAF uptake, and clinical outcomes are lacking.
- This study investigated clinician experiences with the RAF in women of childbearing potential prescribed valproate.
Purpose of the Study:
- To survey clinicians administering the Valproate Risk Acknowledgement Form (RAF).
- To understand clinician perspectives on RAF identification, uptake, effects, and reactions.
- To assess clinical outcomes, particularly seizure control, in women taking valproate.
Main Methods:
- A national online survey was distributed to UK clinical specialists qualified to administer the RAF.
- The survey captured quantitative and qualitative responses from clinicians.
- Data from 215 respondents representing over 4775 patient encounters were analyzed.
Main Results:
- Most patients (90% with epilepsy) continued valproate.
- Seizure control deteriorated in 33% switching to levetiracetam and 43% to lamotrigine.
- Only 7% experienced seizure control deterioration when continuing valproate (P < .001).
Conclusions:
- A significant proportion of clinicians (33%-43%) reported seizure control worsening in women switched from valproate.
- Informed consent necessitates providing women with this information before medication changes.
- Systematic, automated data capture linking online RAFs to patient outcomes is crucial for monitoring.
- Limited data exists for valproate use in non-epilepsy indications.
Keywords:
congenital malformationsinformed consentmedicines and healthcare products regulatory agency (MHRA)neurodevelopmental disabilityrisk acknowledgement form (RAF)teratogenicityvalproateMore Related Videos
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