Abstracts

RATIONALE: Recent data evaluating the knowledge of healthcare issues in women with epilepsy (WWE) supports a lack of knowledge concerning a variety of related topics. While there are multiple educational resources available for WWE, they rightfully expect health care professionals (HCP) to be knowledgeable and to disseminate relevant information. Although previous authors have focused on this topic, the current survey may be more relevant as it includes a broader range of topics, does not contain questions perceived to be misleading, and emphasizes pertinent clinical concepts rather than percentages or specific terms.
METHODS: A variety of health care professionals employed at a large tertiary care center were approached to complete an anonymous one page, 13-item knowledge of womens issues and epilepsy (KOWIE-2) questionnaire. The KOWIE-2 was modified from a previous survey developed for patients (KOWIE-1). Content validity was established by allowing field experts to evaluate the survey prior to data collection. To eliminate questions that were misleading or difficult to comprehend, the survey was pilot tested. There was no incentive for participation; it was completely voluntary.
RESULTS: Sixty-eight of 120 surveys were completed. Twenty-five percent of respondents were neurologist (n=17), 13.2% OB/GYN physicians (n=9), 32.3% nurses (n=22), 10.3% were social workers (n=7), 3% internist (n=2), 13.2% were medical students (n=9), and the remaining 3% were included under other (n=2). The mean total correct score for all disciplines was 41.2% with an interquartile range and SD of 18.1% to 64.3% and 23.1%, respectively. Nurses (28.3% correct) and social workers (30.2% correct) were least knowledgeable, while neurologist obtained the highest percent correct (61.4%). Approximately 20% of all respondents believed that WWE should stop taking their AEDs when becoming pregnant and 21% did not know the importance of taking folic acid prior to conception. Seventy percent did not know that women taking AEDs could breast feed. Forty percent were unaware of the effects of enzyme inducing anti-epileptic drugs (EIAED) on BCPs. Other low scores pertained to the association between VPA and polycystic ovaries (10% correct), the hemorrhagic disorder associated with EIAEDs (21% correct), the effect of primary AEDs on bone mass (30% correct), and the potential correlation between endogenous hormones and seizures (40% correct). As expected, HCPs with greater exposure to WWE ([gt]6 patients per month) were more knowledgeable than those with fewer exposures. In terms of perceptions, less than 50% were [dsquote]comfortable treating pregnant WWE[dsquote], 80% felt that pregnant WWE should be evaluated by a neurologist, and 78% were interested in learning more about WWE.
CONCLUSIONS: Health care professionals are not knowledgeable about concepts related to WWE. Although neurologist obtained the highest percent correct, they did not respond accurately to approximately 40% of the included questions. This study supports the need to better educate those treating and evaluating WWE. The lack of awareness in nurses and social workers is an important finding as these providers play a pivotal role in patient education. Improving the knowledge of HCPs in general may enhance the awareness of WWE, leading to improved outcomes.