G76(P) Management of hypertonia in children and young people (CAYP) with intrathecal baclofen (ITB) in a tertiary centre

Abstract

Programme (PPP)'. Childbearing potential is defined as a premenopausal female capable of becoming pregnant.Hospital specialists are required to review females on valproate to establish childbearing potential and only continue if other treatments are ineffective and pregnancy is excluded by means of a serum pregnancy test. PPP should be started if valproate is to be continued ensuring there is understanding of the risks to an unborn child and an Annual Risk Acknowledgement form (ARAF) is completed. Aim Identify all female paediatric patients taking valproate under the care of a paediatrician in a district general hospital in November 2018 to assess compliance with PPP. Method 163 female paediatric patients identified via clinic lists of 5 consultants seeing Epilepsy and neurology patients. Results 12 (7.4%) were taking Valproate (mean age 10; range 4 to 16). 5 out of the 12 (41.7%) had a signed ARAF. 1 GP and 1 pharmacist had alerted hospital specialists of 2 of the 12 (16.7%) patients. There was no documentation regarding contraception. 2 patients without an ARAF (16.7%) were in the process of being weaned off valproate following the MHRA guidance. Conclusion Following departmental presentation in February 2019, 2 further female patients were weaned off valproate and consultants have been made aware of PPP and familiarised with the ARAF. Concerns were raised by specialists regarding the ethics of contraception in young females that may lack capacity to consent. On the 29th March 2019 A Guidance Document on Valproate Use in Women and Girls of Childbearing Years was released. It provides practical information, guidance and sources of further support to clinicians managing patients on Valproate. Valproate is now under strict regulation and use is expected to be in line with the modified ARAF and updated guidance.