Building a Multidisciplinary Specialty Clinic for Pregnant Women with Epilepsy: A Pilot Project
Abstract number :
1.4
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2204793
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Suparna Krishnaiengar, MD – University of Florida Health Sciences Center, Jacksonville, Florida; Deepa Nagaraju, MD – Neurology – University of Florida Health Sciences Center, Jacksonville, Florida; Katherine Zarroli, MD – Neurology – University of Florida Health Sciences Center, Jacksonville, Florida; Felicia Smith, PhD – Neurology – University of Florida Health Sciences Center, Jacksonville, Florida; Dedra McKinney, BA – University of Florida Health Sciences Center, Jacksonville, Florida; Catrina Graham, PharmD, CPh, BCACP – University of Florida Health Sciences Center, Jacksonville, Florida; Adrienne Deberry, PharmD, CPh, BCACP, CSP – University of Florida Health Sciences Center, Jacksonville, Florida
Rationale: Women with epilepsy have unique challenges that become exaggerated during pregnancy. Hormonal and pharmacokinetic changes may influence seizure control and anti-seizure medication (ASM) levels during pregnancy. Early reports of teratogenicity due to ASMs date back to 1960s and due to the fear of fetal harm some pregnant women choose to discontinue their ASM. This may also lead to misconceptions regarding breast feeding. What is crucial in this population is education and counselling. We proposed that a multidisciplinary clinic may provide the necessary guidance to epilepsy patients during pregnancy.
Methods: We designed a monthly outpatient multidisciplinary clinic to care for epilepsy patients during pregnancy and post-partum phase. The epileptologist focuses on clinical evaluation and medication changes. The pharmacist explains the ASM in relation to safety, adverse effects, drug level monitoring and importance of folic acid. Pharmacists providing education on ASM can improve patient confidence in management of epilepsy. The social services coordinator (SSC) imparts education to ensure a healthy social environment and provides resources individualized to patients while addressing their concerns. SSC also helps assess the domestic, financial and health insurance situations and navigate the healthcare system to coordinate care. The epilepsy coordinator counsels on stress management, breast feeding and pregnancy registries.
Results: The clinic provides patients a comprehensive care using a one-stop-shop approach to have their questions answered and needs addressed by various disciplines in a single visit. The expected outcome is better seizure control leading to better outcome of pregnancy and decreasing health care costs and increasing patient satisfaction.
Conclusions: The monthly multidisciplinary clinic for pregnant women with epilepsy will empower them with information to manage their epilepsy well and may alleviate fear associated with pregnancy. Having established this pilot project, our goal is to expand these services to all women with epilepsy with childbearing potential.
Funding: None
Health Services (Delivery of Care, Access to Care, Health Care Models)