Concerns around the use of valproate during pregnancy have been highlighted for some time now, but recent research shows that every baby exposed to the epilepsy drug is at some degree of risk. The scale of the issue, and the harm caused, is bigger than that caused by thalidomide.

Yes, you read that right. During a parliamentary debate in 2017, MPs claimed that since the 1970s an estimated 20,000 babies could have been born in the UK with severe congenital defects and developmental problems as a result of their mothers taking valproate during pregnancy. In the case of thalidomide, the number of babies affected in the UK was around 2,000, according to the Thalidomide Society, partly due to the serious risks of harm being highlighted early and appropriate action being taken.

Yet women prescribed valproate are still unaware of the risks of taking it should they become pregnant. Efforts to raise awareness of the risks around valproate-containing medicines and pregnancy have just not been successful enough to date.

Credit: CCA

The CCA has tackled this situation through its Community Pharmacy Patient Safety Group. This group brings together medication safety officers from all CCA member companies, other community pharmacy organisations, and representatives from the National Pharmacy Association.

This group provides a forum to openly share and learn from each other. We consider how learning from patient safety incidents can be applied across the pharmacy network and the wider NHS, and create the opportunities and resources to do so.

The group has recently worked closely with several other national pharmacy bodies represented on the Medicine and Healthcare products Regulatory Agency (MHRA)’s valproate stakeholder network.

We produced a resource for community pharmacists and their teams to use when supplying female patients with valproate, which remains a vital and effective treatment for conditions including epilepsy and bipolar disorder.

Resources for pharmacy teams

The resource includes a decision pathway and key points for consideration, to facilitate sensitive conversations between the pharmacy team and patients. It will help pharmacy professionals understand how to use the new valproate tools from the MHRA, which arrived in pharmacies across the country this month.

Alongside the joint resource, CCA members have also designed a practice-based audit tool for all UK community pharmacy teams to use in reviewing their support for girls and women taking valproate to assess what changes may need to be made. All pharmacy teams are encouraged to get involved in the audit. We’ve had lots of help in promoting its use, including from Pharmaceutical Services Negotiating Committee, the Royal Pharmaceutical Society, NHS England regional teams, and local pharmaceutical committees across the country.

We really hope that our new resource helps to raise awareness across the sector and, in turn, their patients.

Janice Perkins is chair of the Community Pharmacy Patient Safety Group and superintendent at Well Pharmacy.

Further details about the joint information resource and the CCA’s audit are available here.
For more on valproate safety read C+D’s CPD article.