Consent to contraceptive treatment among clients with epilepsy
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Consent to contraceptive treatment among clients with epilepsy

Rohit Shankar Consultant in adult developmental neuropsychiatry, Cornwall Partnership NHS Foundation Trust, Truro
Meriel Bradley Healthcare assistant, Cornwall Partnership NHS Foundation Trust, Truro
Caryn Jory Epilepsy specialist nurse, Cornwall Partnership NHS Foundation Trust, Truro
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.

Learning Disability Practice. 16, 10,27-30. doi: 10.7748/ldp2013.12.16.10.27.e1485

Correspondence

rohit.shankar@cft.cornwall.nhs.uk

Peer review

This article has been subject to double blind peer review

Conflict of interest

None declared

Received: 28 June 2013

Accepted: 30 September 2013