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Association of British Neurologists: Audit of Sodium Valproate in Women of Childbearing potential
Information for each neurologist to send to the ABN
Part B. Following the audit using the
tool in part A
, please use this form to summarise the findings and submit to the ABN
For each option please enter a percentage totaling to 100%
*
1.
Of the women of childbearing potential, you see who take Valproate, what proportion take this for
(Required.)
Generalised epilepsy
Focal epilepsy
Developmental and epileptic encephalopathies (DEE) including Dravet’s syndrome
Unclassified
Other (please specify below)
Other
*
2.
In what proportion of women of childbearing potential you see who are taking Valproate was there documentation in the notes/clinic letters that the woman has been informed about the teratogenic risks of VPA and that the info leaflet has been shared as per MHRA requirements?
(Required.)
Yes (in the last 12 months)
Yes (but more than 12 months ago)
No
*
3.
In what proportion of women of childbearing potential taking Valproate was there documentation in notes/clinic letter that the woman has been informed about the need to be on highly effective contraception or that the need for highly effective contraception is not deemed appropriate?
(Required.)
Yes (in the last 12 months)
Yes (but more than 12 months ago)
No
*
4.
In what proportion of women of childbearing potential taking Valproate was there a signed Annual Risk Acknowledgement form in the notes and evidence sent to GP/patient?
(Required.)
Yes (<12 months old)
Yes (>12 months old)
Yes but incorrectly completed
No
*
5.
How many women were included in the survey?
(Required.)
Optional Questions
6A.
Data submitted is from
Single Neurologist
Departmental audit
6B
. Data submitted is from
England - London & South east
England - East Anglia
England - Mersey & North west
England - Northern
England - Oxford
England - South west
England - Trent
England - Wessex
England - West Midlands
England - Yorkshire
Wales
Scotland
Northern Ireland
6C.
Data submitted is from
Epilepsy Specialist
General Neurologist
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