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Research

Valproate use in women aged 15–44 years: an observational study in general practice

Samantha J Beardsley, Isabel Dostal, James Cole, Ana Gutierrez and John Robson
BJGP Open 2021; 5 (2): BJGPO.2020.0104. DOI: https://doi.org/10.3399/BJGPO.2020.0104
Samantha J Beardsley
1 Barts Health NHS Trust, The Royal London Hospital, London, UK
2 Institute of Population Health Sciences, Queen Mary University of London, London, UK
PhD, BMBS
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  • For correspondence: sam.beardsley1{at}nhs.net
Isabel Dostal
2 Institute of Population Health Sciences, Queen Mary University of London, London, UK
MSc
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James Cole
2 Institute of Population Health Sciences, Queen Mary University of London, London, UK
MRCGP
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Ana Gutierrez
3 Institute of Population Health Sciences, Queen Mary University of London, London, UK
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John Robson
4 Institute of Population Health Sciences, Queen Mary University of London, London, UK
FRCGP
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    Figure 1. Number of women prescribed valproate between 2017 and 2020 in East London
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    Figure 2. Change in pre-conception or contraception advice (purple), prescribed contraception (blue), and women receiving advice and/or contraception (orange), normalised to the number of women prescribed valproate

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    Table 1. Demographic characteristics of 330 women aged 15–44 years prescribed sodium valproate between 1 October 2017 and 1 January 2020 in East London
    Age, yearsa n (%)
     15–1938 (12)
     20–2422 (7)
     25–2954 (16)
     30–3469 (21)
     35–3960 (18)
     ≥4087 (26)
    Ethnic group a
     White150 (45)
     Black49 (15)
     South Asian87 (26)
     Other22 (7)
     Unknown22 (7)
    Received pre-conception or contraception advice b 151 (46)
    Prescribed contraception b 90 (27)
     Prescribed LARCc 48 (53)
     Prescribed non-LARCc 42 (47)
    Received advice or contraception b 191 (58)
    • aData relate to most recent record for age and ethnic group. bAt least once during study period. cLong-acting reversible contraception (LARC): copper intrauterine device, levonorgestrel 13.5 mg/19.5 mg/52 mg intrauterine system, and progestogen-only implant. Non-LARC contraception: combined hormonal contraception including combined contraceptive pill, transdermal patch and vaginal ring, progestogen-only pill, progestogen-only injectable depot medroxyprogesterone acetate, condoms, and diaphragms.

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    Table 2. Pregnancy and pregnancy rates by quarter between 1 October 2017 and 1 January 2020 in East London
    Quarter
    10/1701/1804/1807/1810/1801/1904/1907/1910/1901/20
    Total, n 214198194179178162148143142136
    Pregnancies, n a 4110010101
    Pregnancy rate (average per 1000 population)9.92.8
    • aNew pregnancies in this quarter; corrected for one termination or miscarriage.

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    Table 3. Indication for valproate for women included in the first and last quarters of the study period
    ValproateindicationaDataextraction from 1 Oct 2017Data extraction from 1 Jan 2020
    n (%)n (%)
    Epilepsy139 (65)88 (65)
    Bipolar disorder31 (14)20 (15)
    Migraine4 (2)2 (1)
    Learning difficulties5 (2)5 (4)
    Other or unknown35 (16)21 (15)
    Total patients214 (100)136 (100)
    • aLikely indication inferred from recorded long-term conditions on electronic health record.

Supplementary Data

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    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

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Valproate use in women aged 15–44 years: an observational study in general practice
Samantha J Beardsley, Isabel Dostal, James Cole, Ana Gutierrez, John Robson
BJGP Open 2021; 5 (2): BJGPO.2020.0104. DOI: 10.3399/BJGPO.2020.0104

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Valproate use in women aged 15–44 years: an observational study in general practice
Samantha J Beardsley, Isabel Dostal, James Cole, Ana Gutierrez, John Robson
BJGP Open 2021; 5 (2): BJGPO.2020.0104. DOI: 10.3399/BJGPO.2020.0104
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Keywords

  • primary health care
  • valproate
  • women
  • adverse drug related event
  • pregnancy

More in this TOC Section

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  • Responses to the inverse care law in Scottish general practice and the role of the Deep End project: a qualitative study
  • Deprivation and primary care network performance: a national cross-sectional study of the Investment and Impact Fund scheme
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