Improving the prescription of folate to women receiving antiepileptic drugs

• The risk of teratogenicity secondary to AEDs can potentially be reduced with folate.
• We evaluated the rate of co-prescription of AEDs and folate to women.
• Before an educational intervention, the rate of folate prescription was only 20.4%.
• This increased to 64.6% following a simple educational intervention (p < 0.001).
• This has the potential to improve the cognitive/physical development of children.

SummaryIn women of childbearing potential (WCP) on antiepileptic drugs (AEDs), there is an increased risk of teratogenicity. This can potentially be reduced with folate supplementation. We evaluated the rate of co-prescription of AEDs and folate to WCP by non-epileptologist Neurology attendings and residents before and after an educational intervention. During the initial 3 month survey, 54 WCP were prescribed ≥1 AEDs. Prior to the intervention, the rate of co-prescription of AEDs and folate was 20.4%. This was higher when neurologists were prescribing AEDs for epilepsy (34.4%) versus other disorders (0%, p = 0.02). In the 3 months following the intervention, 48 WCP received AEDs. The rate of co-prescribing folate increased to 64.6% (p < 0.001). Neurologists treating epilepsy continued to be more likely to prescribe folate (86.4%) than neurologists treating other conditions (46.2%, p = 0.006).