Virtual clinics for paediatric epilepsy during the Covid-19 pandemic - Is this a successful model for service delivery?

Objective: In March 2018, MHRA endorsed the view that sodium valproate should not be used in woman or girls in child bearing age unless she has PREVENT (pregnancy prevention programme) in place With COVID-19 and additionally a recent gap in service in the paediatric epilepsy team, we wanted to firstly review the number of female patients on sodium valproate and then review implementation of pregnancy prevention programme (PPP) Methods: Data was collected from 2019 audit and patient list from the epilepsy clinic Lists were also requested from our paediatric pharmacists Results: 9 of 12 patients on previous lists were identified as being in child bearing age however following review only 4 continue on sodium valproate, 4 were switched and one weaned off her medication 4 new patients were identified since last audit with initial documented discussion In total, 8 girls required up-to-date Annual Risk Acknowledgement Form (ARAF), only 2 were completed Conclusion: The outstanding ARAF forms were a result of a temporary gap in service of a paediatric epilepsy lead compounded by cancellation of all outpatient activity due to COVID-19 However, following our review this has been urgently addressed by the team in line with adapted recommendations There is temporary advice for management of annual review during COVID-19 suggesting communicating, if possible, the Valproate Patient guide and ARAF via email and paper forms by post to patients and families with documentation Followed by review of ARAF at appointment Subsequently confirmation of receipt of ARAF by patient can be via email/messaging service Failure to receive response with patient agreement at 2 weeks needs chasing up This has been presented at the 'Trust Audit Meeting' to share our experience of adapting services with COVID-19 considering a second wave of COVID-19 may lead to further cancellation of out patient activity