Victor Olotu Locum consultant psychiatrist, Devon Partnership NHS Trust
Rohit Shankar and colleagues discuss findings from an audit of how GPs prescribe birth-control pills to women with learning disabilities who also take anti-epileptic drugs
Aim To improve the treatment, care and monitoring of women with learning disabilities who receive oral contraceptive pills and long-term anti-epileptic drugs.
Method A questionnaire based on standards from national and good-practice guidelines was devised and sent to all GP surgeries in Cornwall. The questions concerned:
The rationale for birth control and/or behaviour management in the client group.
Whether anti-epileptic drugs interactions and adverse effects were being considered.
Whether clients demonstrate sufficient mental capacity to make informed choices about birth control and, if not, whether best-interest processes are being followed.
Results All 67 surgeries in Cornwall were asked to answer the questionnaire and 29 did so. Results showed a significant paucity of understanding of the relevant legal issues, including the Mental Capacity Act 2005; communication issues, such as use of pathways and easy-read documents; and clinical issues, for example concerning the interactions and long-term effects of medications.
Conclusion Copies of an easy-read leaflet for women with learning disabilities and a flowchart describing the best way to manage such patients were sent to GPs around Cornwall to ensure that they follow a single process in securing the consent of women with learning disabilities to birth-control, and thereby avoid any associated physical, financial and legal problems.