Brief intervention reduces prescription of sodium valproate in women of childbearing age
OBJECTIVE: Sodium valproate's teratogenicity has prompted increasing restrictions to its use. Our initial audit 2 years prior demonstrated continuing hazardous prescription to women of childbearing age in a New Zealand psychiatric inpatient unit, consistent with nationwide dispensing data.
METHOD: Following a service-wide educational intervention and application of "black box" warnings, we conducted a follow-up audit of valproate prescription in the same inpatient unit by reviewing records of women admitted over a 10-month period (March 2020-January 2021). Results were compared with local and international guidelines, and against data from our initial audit.
RESULTS: Two hundred and sixty-one women of childbearing age were admitted over the sampling period, 26 of whom (10%) were prescribed valproate on discharge. Over three quarters (77%) of these patients had diagnoses other than bipolar affective disorder, valproates only approved psychiatric indication in New Zealand. Following intervention, significant improvements were observed in several key indicators of prescribing quality: pregnancy testing, documentation of contraception status, and discussion of teratogenic risk.
CONCLUSIONS: Following intervention, re-audit demonstrated reduced prescription of valproate and improved management of its teratogenic risk in women of childbearing age receiving inpatient psychiatric care. These results demonstrate the value of a systematic approach to improve prescribing practice.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
|---|---|
| Enthalten in: |
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists - 31(2023), 4 vom: 10. Aug., Seite 524-527 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Goldspink, Rachel [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
614OI1Z5WI |
|---|
| Anmerkungen: |
Date Completed 17.08.2023 Date Revised 22.08.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/10398562231169369 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM35540625X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM35540625X | ||
| 003 | DE-627 | ||
| 005 | 20231226064258.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/10398562231169369 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1184.xml |
| 035 | |a (DE-627)NLM35540625X | ||
| 035 | |a (NLM)37035997 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Goldspink, Rachel |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Brief intervention reduces prescription of sodium valproate in women of childbearing age |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 17.08.2023 | ||
| 500 | |a Date Revised 22.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Sodium valproate's teratogenicity has prompted increasing restrictions to its use. Our initial audit 2 years prior demonstrated continuing hazardous prescription to women of childbearing age in a New Zealand psychiatric inpatient unit, consistent with nationwide dispensing data | ||
| 520 | |a METHOD: Following a service-wide educational intervention and application of "black box" warnings, we conducted a follow-up audit of valproate prescription in the same inpatient unit by reviewing records of women admitted over a 10-month period (March 2020-January 2021). Results were compared with local and international guidelines, and against data from our initial audit | ||
| 520 | |a RESULTS: Two hundred and sixty-one women of childbearing age were admitted over the sampling period, 26 of whom (10%) were prescribed valproate on discharge. Over three quarters (77%) of these patients had diagnoses other than bipolar affective disorder, valproates only approved psychiatric indication in New Zealand. Following intervention, significant improvements were observed in several key indicators of prescribing quality: pregnancy testing, documentation of contraception status, and discussion of teratogenic risk | ||
| 520 | |a CONCLUSIONS: Following intervention, re-audit demonstrated reduced prescription of valproate and improved management of its teratogenic risk in women of childbearing age receiving inpatient psychiatric care. These results demonstrate the value of a systematic approach to improve prescribing practice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a audit | |
| 650 | 4 | |a bipolar | |
| 650 | 4 | |a prescribing | |
| 650 | 4 | |a sodium valproate | |
| 650 | 4 | |a teratogen | |
| 650 | 7 | |a Valproic Acid |2 NLM | |
| 650 | 7 | |a 614OI1Z5WI |2 NLM | |
| 650 | 7 | |a Teratogens |2 NLM | |
| 650 | 7 | |a Anticonvulsants |2 NLM | |
| 700 | 1 | |a Pumipi, Toni |e verfasserin |4 aut | |
| 700 | 1 | |a Menkes, David B |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists |d 1993 |g 31(2023), 4 vom: 10. Aug., Seite 524-527 |w (DE-627)NLM095539352 |x 1440-1665 |7 nnns |
| 773 | 1 | 8 | |g volume:31 |g year:2023 |g number:4 |g day:10 |g month:08 |g pages:524-527 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/10398562231169369 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 31 |j 2023 |e 4 |b 10 |c 08 |h 524-527 | ||