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Thornton HF, Fantaneanu TA, Zhang T, Bercovici E, Hrazdil C, Ikeda KM, Kassiri J, Suller Marti A, Pana R, Rezazadeh A, Kobayashi E, Bui E. Real-world practices in reproductive health and counselling for women with epilepsy: A Canadian perspective. Epilepsy Behav 2024; 151:109623. [PMID: 38262329 DOI: 10.1016/j.yebeh.2024.109623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/27/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
Canadian women of reproductive potential living with epilepsy present unique care challenges due to the complex interplay of hormones, seizures, and medications. This study explores reproductive health practices and counselling for women with epilepsy. Through a questionnaire developed by the Canadian League Against Epilepsy women with epilepsy (WWE) workgroup, we are the first to report demographic and real-world practice characteristics of Canadian healthcare professionals providing care for WWE with specific focus on family planning, birth plans, and postpartum care counselling. Among respondents, 76.9% routinely reviewed contraception with patients and an intrauterine device (IUD) was the most popular recommended method (85.3%). With regards to preconception planning, 50% of respondents routinely had a preconception drug level prior to pregnancy. A significant proportion, 44.9%, reported not communicating a neurology-informed birth plan to obstetrical health practitioners. The majority recommended breastfeeding for WWE on anti-seizure medications (92.3%) and regularly provided safety counselling for women in the postpartum period (84.6%). Overall, our study demonstrates that Canadian practice patterns conform reasonably well to existing evidence and guidelines, although important gaps in care exist.
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Affiliation(s)
- Hayley F Thornton
- Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.
| | - Tadeu A Fantaneanu
- Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada.
| | - Tinghua Zhang
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada.
| | - Eduard Bercovici
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
| | - Chantelle Hrazdil
- Division of Neurology, University of British Columbia, Vancouver Coastal Health, Vancouver, British Columbia, Canada.
| | - Kristin M Ikeda
- Division of Neurology, Department of Medicine, Dalhousie University, Nova Scotia Health, Canada.
| | - Janani Kassiri
- Division of Pediatric Neurology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
| | - Ana Suller Marti
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
| | - Raluca Pana
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | - Arezoo Rezazadeh
- Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Eliane Kobayashi
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | - Esther Bui
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Tirukelem H, Nigatu SG, Angaw DA, Azale T. Community Attitude Towards Epilepsy Patients and Associated Factors in South Achefer District, Northwest Ethiopia: A Mixed-Methods Study. Neuropsychiatr Dis Treat 2021; 17:365-377. [PMID: 33603375 PMCID: PMC7881770 DOI: 10.2147/ndt.s292257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Epilepsy, defined as seizure activity that is recurrent, unpredictable, and typically unprovoked. It is one of the most common disorders of the nervous system. Sociocultural attitudes in many African nations continue to have a negative impact on epilepsy management. It has been found that stigma and discrimination against people with epilepsy are more devastating and harmful than the illness itself. This is mainly attributed to misconceptions about the disease with fear and fright of the public on confronting an epileptic seizure. So, the current study assesses the community's attitude toward epilepsy patients and associated factors towards epilepsy in South Achefer District, Northwest Ethiopia. METHODS Community-based cross-sectional study triangulated with the qualitative method was conducted from March 1 to May 30, 2020 in South Achefer District. A systematic sampling technique was used to select a total of 762 individuals. Data were collected by face-to-face interview using a structured questionnaire and analyzed using SPSS version 23. Logistic regression analysis was performed and P < 0.05 with a 95% confidence interval was considered to measure statistically significant variables. For the qualitative study participants were selected purposively. Focus Group Discussion, key Informant Interview, and Individual Depth Interview were conducted until it reaches the point of saturation. Thematic analysis was done by using an open code software version 4.2. RESULTS A total of 753 respondents participated which gave a 98.8% response rate. Among those 60.8% (95% CI: 57.2-64.3) were found to have a favorable attitude towards epilepsy patients. Being informed about epilepsy (AOR=1.47; 95% CI, 1.02-2.11), witnessing seizure in the past (AOR=1.6; 95% CI, 1.14-2.27), and having good knowledge about epilepsy (AOR=2.08; CI, 1.49-2.89) were the variables that showed statistically significant association with a favorable attitude. CONCLUSION The favorable attitude of the community towards epilepsy patients was found high in the study area. Information about epilepsy, witnessing seizure, and knowledge about epilepsy showed a significant association with attitude. Therefore, health professional and health extension workers should provide a larger and comprehensive community-based education to enhance people's knowledge about epilepsy to bring attitude change against a negative attitude towards epilepsy.
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Affiliation(s)
- Hewan Tirukelem
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Gedlu Nigatu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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