2305 – Audit On Effects Of Mood Stabilisers On Women's Health - Informed Decision Making

Abstract

Introduction

There are growing concerns on use of certain psychotropic medications on women's reproductive health, pregnancy and lactation. Lithium, Sodium valproate, Carbamazepine and Lamotrigine are recommended by National Institute of Clinical Excellence (NICE) in treatment of Bipolar Disorder. While treatment of Bipolar disorder is crucial, it is imperative that there is clear communication between patients, carers and health professionals to enable patients in making informed decisions about their care

Objectives

NICE recommends that healthcare professionals should give relevant information at every stage of assessment and treatment. They should discuss contraception and risks of pregnancy. Furthermore, it is good practice to assess capacity of service user's to consent to treatment. This enables service user to make well-informed decision.

Aims

To find out if relevant steps were taken to aid women in making well-informed decision regarding their treatment i.e by verbal communication and providing written information.

Methods

We retrospectively analysed electronic patient record of women meeting inclusion criteria.

Results

Out of 616 women, 119 met the inclusion criteria. Patients’ ages ranged from 20 to 55. 52% were on Lithium, followed by Sodium Valproate(22%), Lamotrigine(14%) and Carbamazepine(12%). There was evidence of verbal communication in only 35% and provision of written information in only 11%. Contraception advice was documented in only 24%. Documentation of assessment of capacity to consent to treatment was found only in 31%.

Conclusion

There is lack of adequate communication between clinicians and patients. There are several possible explanations for this finding with one of the main reasons being poor documentation.