Abstracts

Rationale: Several studies have shown that counseling of women with epilepsy on pregnancy-related issues is suboptimal. As a result, women with epilepsy may be left with insufficient knowledge on AED interactions with contraceptive pills, malformation risks, drug-level monitoring, and safety issues. Consoling on pregnancy-related issues is one of the AAN quality parameters for epilepsy care. Over the last years, there has been a marked increase in the use of digital health services in Sweden. Patients can today access their medical records online and use different forms of internet-based communication with health care providers. We developed an online platform for information on pregnancy-related AED issues and communication regarding drug levels and dosage during pregnancy.  Methods: The national online platform for healthcare (www.1177.se) was used. The platform allows confidential communication and is approved for healthcare use. Two epilepsy nurses and two neurologists developed two modules; one containing information for all women with AED-treated epilepsy of childbearing age and the other specifically for pregnant women. The modules were launched during the spring of 2019. Patient seen by epilepsy nurses were offered to receive information through the modules as a supplement to standard care. As of 15 May 2019, we have invited ten women of childbearing age with epilepsy (information module) and thirteen pregnant women with epilepsy (pregnancy module, this was launched first). We evaluated the number that actually used the online modules following the invitation. Results: The information module contains information on AED interactions with contraceptive pills, malformation risks, advice on folic acid supplementation, delivery, safety issues, and breast-feeding. The pregnancy module sends a text message and an email to the patient at set intervals to remind the patient to leave a serum drug level and allows the epilepsy nurse to communicate dose changes. A total of 4 / 10 invited patients had accessed the information module following invitation. A total of 11 / 13 invited patients had accessed the pregnancy module.  Conclusions: There seems to be a high acceptance of online information on pregnancy-related issues in women with epilepsy of childbearing age. A substantial proportion of women who are interested in receiving online information also seem to access the information after visit to an epilepsy nurse. Online communication on serum levels and dosage during pregnancy seems feasible. Development of online resources may improve counseling of women with epilepsy on pregnancy-related issues.  Funding: No funding