Women's issues

New Quality and Outcomes Framework (QOF) indicator

The QOF is a set of indicators against which GPs score points for carrying out set actions, with greater financial rewards for those who score more points. On 1 April 2011, a new indicator for epilepsy was launched. This indicator rewards GPs who give women under the age of 55 years regular access to information and counselling. The women must be taking antiepileptic drugs and the information and counselling given is about contraception, conception and pregnancy.

Epilepsy Action put forward a proposal for this indicator in 2007. During the years that followed, we submitted emerging evidence to NICE to prove the need and value of the proposed indicator. We are delighted that as a result of our efforts, this indicator (Epilepsy 9) has now been accepted.

This counselling will enable women to make informed decisions about their health. For example, which contraception to use to minimise the risk of unplanned pregnancy, and which anti-epileptic drug and dose to take when preparing for pregnancy. From these regular discussions, GPs are more able to identify which women should be referred to their specialist for pre-conception counselling. Ultimately, the QOF should mean that fewer babies with physical malformations or neurological problems will be born to women with epilepsy.

Medicines and healthcare products regulatory agency asked to review the safety of taking sodium valproate in pregnancy

Epilepsy Action is currently lobbying the Medicine Health Regulations Authority (MHRA) to review the safety of prescribing sodium valproate to women of child bearing potential. Sodium valproate is an anti-epileptic drug (AED) that has helped many people to achieve good seizure control. Unfortunately, taking this AED during pregnancy is associated with a significantly higher risk of malformations and neurodevelopment problems in the baby. Neurodevelopment is the development of the nervous system and problems can affect speech, communication and movement.

Epilepsy Action has asked MHRA to make sure patient information leaflets have the same level of information across all brands of sodium valproate (including Epilim and Episenta). These leaflets should provide accurate information about the risks associated with pregnancy. This information would help women to make an informed choice of whether or not to seek treatment with another type of AED. Additional information on contraception would help women to make an informed choice of which contraceptive to use. This could help to reduce the risk of becoming pregnant while taking sodium valproate.

Please note, there are risks associated with having frequent uncontrolled seizures in pregnancy. Therefore to reduce the risk of uncontrolled seizures, women are advised to continue to take their AEDs as normal in pregnancy. If you are interested in this specific aspect of our campaigns work, please email your details to ncrosby@epilepsy.org.uk