Abstracts

Rationale: New guidelines have been established by the American Academy of Neurology regarding issues related to pregnancy for women with epilepsy. It is unclear what the level of awareness of the updated guidelines is amongst health professionals involved in neurological care. Our objective was to assess the current level of knowledge regarding women s issues related to pregnancy in neurologists and neurology residents. Methods: A questionnaire was developed to assess physician knowledge of current guidelines for women with epilepsy and pregnancy in the Calgary Health Region, Emphasis was placed upon knowledge of pregnancy-related risks associated with specific anti-epileptic drugs. The questionnaire was distributed in person to neurologists and neurology residents in one tertiary care centre. Descriptive statistics were obtained for all variables. Independent sample t-tests were used to assess the association between level of practice and knowledge. Pearson s correlation was used to assess the association between the proportion of epilepsy patients in one s practice and knowledge of women s issues in epilepsy. Results: Thirty-three physicians have completed the survey (response rate = 94.3%), with an average score of 51.36%. Staff physicians comprised 25 out of 33 completed surveys. Residents were more likely to state that this information was important to their practice than staff physicians, but no significant difference was noted in their overall scores (t = -0.408, p=0.686). No significant difference was noted in final score between males and females (t= - 0.149, p=0.882). A significant positive correlation (Pearson s correlation = 0.455, p=0.025) was noted between the proportion of epilepsy patients in one s practice and final score. Despite the fact that the majority of respondents were not epileptologists, and only followed patients with epilepsy while they were on the inpatient neurology ward service, 94% of them were able to correctly identify that valproate substantially increases the risk of major congenital malformations; however, only 55% were aware that this drug crosses the placenta. Only 40% of physicians knew that there was good evidence of a dose-response relationship between valproate and the risk of major congenital malformations, and only 6% were aware of a similar relationship for lamotrigine. Additionally, a quarter of physicians knew that women should be seizure-free for 9 months prior to conception to ensure a high likelihood of a seizure-free pregnancy. Conclusions: More knowledge translation efforts are required to increase physician knowledge of issues related to pregnancy for women with epilepsy. Increased awareness and applications of the guidelines in practice should result in provision of better care for women with epilepsy of reproductive ages. Steps need to be taken to address this knowledge gap.