Croydon neurology: audit of sodium valproate prescription in women of childbearing age

<h3></h3> MHRA recommends that women of childbearing potential on Valproate need to have annual reviews, complete a risk acknowledgement form (ARAF) to ensure they understand the teratogenic effects and are on the pregnancy prevention programme (PREVENT). This audit determined Croydon’s adherence to the MHRA guidance. Electronic prescribing data and our local epilepsy database identified 30 women; of childbearing age (age 16-55) and prescribed Valproate for a neurological indication in Croydon from 01/08/2021 to 01/12/2022. NHS England Neurology dashboard shows that in Southwest London there are fewer women on valproate (30.18 per 100k population) compared to the national average of 41.60. 40% (12/30) of the women were deemed high risk of pregnancy and 83% (10/12) of these were on highly effective contraception. 90% (27/30) of women had ARAF completed in the preceding 1 year and 85% (23/27) of these had proof that the form was sent to the GP. It remains challenging to extract the key information for this audit due to lack of a centralised database. There is an urgent need for a national database (with local solutions in the interim) with inputs from secondary and primary care. The recent MHRA guidance published in December 2023 makes this even more imperative.