Quality improvement project improving awareness of family planning risks with valproate in male patients.

Abstract (English)

BACKGROUND: Valproate, commonly used for epilepsy and bipolar disorder, carries known teratogenic risks when taken by women during pregnancy. In 2023, the Medicines and Healthcare products Regulatory Agency (MHRA) issued updated guidance suggesting a possible link between valproate use in males around conception and neurodevelopmental disorders in offspring. However, awareness among male patients and documentation of advice in general practice remains inconsistent. AIM: To ensure that 100% of male patients on valproate were informed of MHRA guidance regarding family planning risks and advised on effective contraception within a 2-month period. METHOD: Using EMIS, 22 male patients on valproate were identified. An Accurx text message was sent outlining MHRA guidance, contraception advice, and encouraging contact if planning a family. The text auto-coded advice into the EMIS record. Follow-up phone calls were made over two attempts to confirm receipt and provide verbal guidance where needed. RESULTS: All 22 patients received the text; only one responded. Phone contact was successful with 18 patients: eight confirmed receiving the text, and 10 had not. Five were already aware of the MHRA alert, while 13 were informed during calls. Four patients could not be contacted. No patients requested further information or took additional action such as starting contraception or seeking pharmacist advice. CONCLUSION: This quality improvement project improved documentation and patient awareness of valproate-associated family planning risks. Text messaging alone was ineffective; personalised phone calls were more successful. Future strategies should include routine medication reviews, pharmacist-led discussions, and system alerts to ensure ongoing patient education.