This is a web-based activity designed to help you evaluate your current clinical care for pre-conception counseling and pregnancy planning for people with epilepsy of childbearing potential. The focus for this performance improvement project is to increase the percentage of patients with epilepsy of childbearing potential that are seen in the clinic who receive pre-pregnancy counseling. Pre-pregnancy counseling includes the discussion of the interaction of anti-seizure medications and contraception, teratogenicity of anti-seizure medications, and optimizing folic acid use. 

The activity is comprised of 3 stages:

Stage A – Perform a quality improvement evaluation that involves reviewing charts for 5 patients with epilepsy of childbearing potential. Evaluate if these patients were adequately counseled and documentation was provided on the interactions between anti-seizure medications and contraception, teratogenicity of anti-seizure medications, and folic acid use.

Stage B – Based on the results of Stage A, develop, and implement a plan to optimize pre-pregnancy counseling. This could include educating and updating providers on the most recent guidelines regarding pre-pregnancy counseling in epilepsy patients, developing and distributing hand-outs to patients and caregivers discussing these topics, working with pharmacy to discuss and document interactions between contraception and anti-seizure medications and the importance of folic acid use, and developing EHR phrases for ease of documentation about these topics. 

Stage C – Evaluate the impact of your intervention by performing a second review of 5 patient charts and applying the metrics in Stage A to assess whether there was an increase in percentage of patients with epilepsy of childbearing potential that received pre-pregnancy counseling. 

The slide set, word document and PDF , Performance Improvement Project: Family Planning for People with Epilepsy with Childbearing Potential (PWECP) provides additional information about the activity objectives, rationale, and process. 

1. Provide adequate pre-pregnancy counseling to people with epilepsy of childbearing potential
2. Recognize the importance of family planning in people of childbearing potential with epilepsy (PWECP).
3. Understand and be able to discuss the interactions between contraception and anti-seizure medications, the teratogenicity of anti-seizure medications, and the importance of optimizing folic acid.
4. Counsel patients on adverse interactions between ASMs and contraception that may result in unplanned pregnancy or provoked seizures.

Primarily epileptologists and Advanced Practice Providers providing care to this patient population. Secondarily, other providers such as pharmacists and nurses might benefit from this practice improvement project. 

• Read the needs statement, target audience, learning objectives, and planner/faculty disclosures.
• Complete stages A, B and C online or printed out. 
• Complete the evaluation.

Faculty, Planning Committee, Reviewers’ Disclosures of Financial Relationships

In accordance with the ACCME Standards for Commercial Support, the AES requires that any person who is in a position to control content of a CME activity must disclose all relevant financial relationships that they have with a commercial interest. The following individuals contributed to this activity’s content.

Faculty Authors & Planners
Abrar Al-Faraj, MD
Jonathan Williams, MD
Leah Blank, MD, MPH
Rebecca Spiegel, MD, MA, FAES
Sarita Maturu, DO
Barbara Decker, MD, MSCE

AES Staff
Lauren Orcuiuoli, MBAH, MPH, AES, Senior Manager, Clinical Activities

AES Staff involved in this activity have indicated they have no financial or other relationships to disclose relevant to this activity.

Resolution of Conflicts of Interest

It is the policy of the American Epilepsy Society to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. In accordance with the ACCME Standards for Commercial Support of CME, the AES implemented the mechanisms of prospective peer review of this CME activity, to identify and resolve any conflicts. Additionally, the content of this activity is based on the best available evidence.

Unapproved Use Disclosure

The American Epilepsy Society requires CME authors to disclose to learners when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information. Information about pharmaceutical agents/devices that is outside of U.S. Food and Drug Administration approved labeling may be contained in this activity.

Contact Information

For further information on this activity contact the American Epilepsy Society at education@aesnet.org or call 312.883.3800.

Commercial Support

No commercial support was received for this activity.

Privacy and Confidentiality

The American Epilepsy Society respects the privacy and confidentiality of users of this CME activity. You may access the privacy statement for this activity here.

Policy on Commercial Support and Conflict of Interest

As an ACCME-accredited provider the American Epilepsy Society must ensure 100% compliance with the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities. The American Epilepsy Society has implemented mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity

Disclosure of Unlabeled/Unapproved Uses

This educational activity may include references to the use of products for indications not approved by the FDA. Faculty have agreed to disclose intent to discuss any off-label, experimental, or investigational use of drugs, devices, or equipment or devices in their presentations.  Furthermore, faculty have attested that all the recommendations involving clinical medicine they make in this activity will be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients; and, all scientific research referred to, reported, or used in their presentation in support or justification of a patient care recommendation will conform to the generally accepted standards of experimental design, data collection and analysis.  Faculty opinions expressed with regard to unapproved, investigational or experimental uses of products are solely those of the faculty and are not endorsed by the American Epilepsy Society.

Disclaimer

This CME activity is for educational purposes only and does not constitute the opinion or endorsement of, or promotion by, the American Epilepsy Society. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label, investigational and/or experimental uses.