Competency in the management of women of childbearing age with epilepsy among primary care and specialist doctors in Estonia

Ringo L Teesaar; Nele Taba; Aleksei Rakitin

doi:10.1016/j.ebr.2023.100599

Competency in the management of women of childbearing age with epilepsy among primary care and specialist doctors in Estonia

Epilepsy Behav Rep. 2023 Apr 5:22:100599. doi: 10.1016/j.ebr.2023.100599. eCollection 2023.

Authors

Ringo L Teesaar¹, Nele Taba², Aleksei Rakitin^{1

3}

Affiliations

¹ Neurology Clinic, Tartu University Hospital, L. Puusepp Str, 8H, 50406 Tartu, Estonia.
² Estonian Genome Center, Institute of Genomics, University of Tartu, Riia Str, 23b, 51010 Tartu, Estonia.
³ Department of Neurology and Neurosurgery, University of Tartu, L. Puusepp Str, 8H, 50406 Tartu, Estonia.

Abstract

Objective: Although abundant new information has emerged in the last decade(s) on the management of women with epilepsy (WWE), whether said knowledge has reached clinical practice remains largely unknown. We assessed knowledge of this matter among primary care and specialist doctors in Estonia.

Methods: This study was conducted via an online questionnaire, which was used to explore healthcare specialists' awareness in five domains: pre-pregnancy counseling, contraception, side effects of antiseizure medications (ASMs), and the management of epilepsy during pregnancy and in the peri- and postpartum periods.

Results: The survey response rate was low - 8.14%. Knowledge of epilepsy management in WWE was inconsistent among different medical specialists. The median numbers of correctly answered questions among gynecologists, neurologists, and general practitioners were 7, 6.5, and 3 of 10, respectively. Gynecologists were more informed about appropriate contraceptive methods. Neurologists were more familiar with ASM side effects. General practitioners' knowledge level for this topic was low. Surprisingly, only 30.8% of general practitioners were aware of the high teratogenic potential of valproate.

Conclusions: We observed significant knowledge gaps regarding the optimal treatment of WWE of reproductive age. To improve epilepsy management, doctors' awareness of treatment considerations for this patient group needs to be increased.

Keywords: Antiseizure medications; Awareness; Contraception; Pregnancy; Women with epilepsy.