Bone health in patients on epilepsy medication – a Quality improvement project in primary care

<h3></h3> Anti-epileptic drugs such as Carbamazepine, Phenytoin, Primidone, Phenobarbital and Sodium Valproate carry an increased risk of bone demineralisation and osteoporosis. NICE guidance suggests that screening and appropriate supplementation for this is required. This study aimed to investigate how many patients had been informed of the bone demineralisation risk of their epilepsy medication and assess the current bone health of the identified patients using blood tests, to provide appropriate management or prophylaxis. An audit was carried out using the General Practices’ database, whereby, out of 61 patients with epilepsy 36 were found to be on one of the aforementioned anti-epileptics. 7 patients were not contacted as per the exclusion criteria. 22 patients were contacted via telephone and invited for a blood test. 7 were contacted via text message and advised to take over the counter supplementation. Of those contactable via telephone, 36% were found to have deficiency in either Vitamin D or bone health parameters. The deficiencies may not be a direct result of the medication, however, it does highlight the importance of screening in these patients, to prevent further aggravation of poor bone health. Education of the risks of the medications and screening being incorporated into epilepsy reviews is recommended.