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Valproate risk form — Surveying 215 clinicians involving 4775 encounters

Angus‐Leppan, H; Moghim, MM; Cock, H; Kinton, L; Synnott Wells, M; Shankar, R (2020) Valproate risk form — Surveying 215 clinicians involving 4775 encounters. Acta Neurologica Scandinavica, 141 (6). pp. 483-490. ISSN 0001-6314
SGUL Authors: Cock, Hannah Rutherford

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Objectives Annual completion of a Valproate Risk Acknowledgement Form (RAF) is mandated in the United Kingdom due to neurodevelopmental risks of in utero valproate exposure. The number of women of childbearing potential taking valproate, the uptake of the RAF within this population and their clinical outcomes is not known or monitored. This study surveyed responses of clinicians administering the RAF to women of childbearing potential taking valproate medications. Materials and Methods Study design—national online survey distributed to clinical specialists throughout the United Kingdom via their national organizations. Participants—clinicians qualified to counsel and administer the valproate RAF (as defined by the Medicines and Healthcare products Regulatory Agency). Main outcome measures—quantitative and qualitative responses regarding identification, uptake, effects and reactions to the RAF. Trial registration—registered at the Clinical Governance and Audit Committee at Royal Free London NHS Foundation Trust Hospital. Results 215 respondents covering more than 4775 patient encounters were captured. Most patients continued on valproate, 90% with epilepsy as the indication. Respondents reported that seizure control deteriorated when switched to levetiracetam (33%) and lamotrigine (43%), compared to 7% when continuing valproate (P < .001). Conclusions 33%‐43% of clinicians reported seizure control deterioration in women changed to alternatives to valproate. Informed consent requires women considering a change are given this information. Systematic capture of data automated through online RAFs and linked to patient outcomes is needed. There remains little data on valproate given for indications other than epilepsy.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Angus‐Leppan, H, Moghim, MM, Cock, H, Kinton, L, Synnott Wells, M, Shankar, R. Valproate risk form—Surveying 215 clinicians involving 4775 encounters. Acta Neurol Scand. 2020; 141: 483– 490., which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: Neurology & Neurosurgery, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Acta Neurologica Scandinavica
ISSN: 0001-6314
Language: en
3 May 2020Published
10 March 2020Published Online
11 February 2020Accepted
Publisher License: Publisher's own licence
Publisher's version:

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