Authors :
Presenting Author: Sara Jacobellis, MS – Boston University Chobanian & Avedisian School of Medicine
Camille Dang, BS – Boston Medical Center; laurie Douglass, MD – Pediatric Neurology – Boston Medical Center; Rinat Jonas, MD – Pediatric Neurology – Boston Medical Center; Rovingaile Kriska Ponce, BS – Boston Medical Center; Natalia Lopez, MD – Boston Medical Center; Madeline Niemann, BA – Pediatric Neurology – Boston Medical Center
Rationale:
Anti-seizure medications (ASM) can lower the efficacy of hormonal birth control (BC), while estrogen-containing BC can increase ASM metabolism altering seizure frequency.
1 Despite these adverse interactions, many youth with epilepsy demonstrate inadequate knowledge about this topic.
2 Thus, there is a need to develop tools that empower youth with epilepsy to make more informed contraceptive decisions. This study assesses the use of a shared decision-making tool to raise awareness of BC and ASM interactions in this population.
Methods:
We created an animated video that gives an overview of possible interactions between BC methods and ASM, mainly increased risk of pregnancy and change in seizure frequency. The video was shown to English-speaking females with epilepsy patients aged 12 and older in a child neurology clinic followed by a discussion with their doctor. Nine patients completed a survey before and after watching the video. We collected demographics, ASM regimen, BC history, prior understanding of the topic using an 11-point Likert scale. Data was analyzed with descriptive statistics and one-tailed paired t-tests (α = 0.05).
Results:
Thirty-three percent of patients reported use of a BC method with potential to interact with ASM. While 67% of patients reported they had a prior discussion about BC and ASM interactions with a doctor, patients rated their knowledge of the subject pre-video as moderately low with high interest in learning more about the topic (Table 1). Patients’ understanding of how BC and ASM interactions can increase risk of pregnancy showed a borderline significant increase post-video (Table 2). Patients also indicated a high likelihood that they would think of the video when choosing a BC method and that they are more likely to start a discussion with their doctor about BC and ASM interactions because of the video.
Conclusions:
Youth with epilepsy need engaging resources that empower them to make informed decisions about BC. The animated video augments patient understanding about BC and ASM interactions even if they had prior discussions with their provider. The tool may influence future patient decision-making regarding BC and empower patients to take an active role in discussing BC with their doctor.
Funding:
Federal Health Resource and Services Administration’s Maternal and Child Health Bureau