Table of Contents
Advances in Psychiatry
Volume 2015 (2015), Article ID 520784, 6 pages
http://dx.doi.org/10.1155/2015/520784
Research Article

Valproate Prescribing in Women of Childbearing Age: An Audit of Clinical Practice

1Pennine Care NHS Foundation Trust, Royal Oldham Hospital, Oldham, Lancashire OL1 2JH, UK
2Pennine Care NHS Foundation Trust, Birch Hill Hospital, Rochdale OL12 9QB, UK

Received 16 June 2014; Revised 13 January 2015; Accepted 22 January 2015

Academic Editor: Holly A. Garriock

Copyright © 2015 Harini Atturu and Adedeji Odelola. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Evidence is accruing regarding the risks of valproate exposure in women of childbearing age. Recommendations have recently been made for a higher standard of prenatal counselling and prescribing practice in respect of valproate use in this patient group. Aim and Method. A reaudit was carried out to review the standard of clinical discussion around teratogenic risk and pregnancy planning offered to women of child-bearing age prescribed valproate. Case notes and prescription charts of women 45 years old or less were examined and compared with the results of a previous audit in 2005. Results. The use of valproate was increased overall by 64% and there was an 18% increase in off-label valproate use. The rate of clinical discussion carried out during commencement declined from 70% to 35% and at annual review from 50% to 22%. There was less clinical discussion in outpatients and in older patients. More than 40% of doctors surveyed were not confident about giving information to women. Clinical Implication. There is a need for a multidisciplinary approach and action at Healthcare Trust level, to increase awareness and reduce risks associated with valproate prescribing in childbearing women.