Barriers and facilitators to healthcare practitioners providing care for pregnant women with epilepsy: A systematic review and narrative synthesis

Hughes, Anita J. and Weckesser, Annalise and Denny, Elaine and Junaid, Fatima and Nelson-Piercy, Cathy and Black, Mairead and Allotey, John and Thangaratinam, Shakila and Dyson, Judith (2024) Barriers and facilitators to healthcare practitioners providing care for pregnant women with epilepsy: A systematic review and narrative synthesis. Seizure, 118. pp. 38-46. ISSN 1059-1311

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Purpose: Despite published guidelines for managing pregnant women with epilepsy, their care is sub-optimal. We undertook a review to establish the barriers and facilitators to healthcare practitioners providing optimal care.
Methods: A systematic search of ASSIA, CINAHL complete, MEDLINE, SCOPUS, and the Cochrane database of systematic reviews between 2013 and 2023 and narrative synthesis.
Results: From 580 potential papers, we included 16 studies. There were a total of 2045 participants across all studies, who consisted mostly of obstetricians/gynaecologists (n=447) and neurologists (n=765) but also included midwives/nurses (n=70), general practitioners (n=107) and pharmacists (n=156) with the others being mixed groups of physicians, advanced practitioners or unspecified. Thirteen studies were questionnaire surveys and three used qualitative methods. Nine tested or asked about practitioners’ knowledge. Although knowledge was generally adequate, practitioners found it difficult to apply in challenging or complex cases. Other barriers included challenges to joint working (between primary and secondary care and between different specialist groups), communication with women and environmental factors such as lack of time and guideline availability. Practitioners expressed the importance of providing good care for pregnant women with epilepsy.
Conclusion: More qualitative studies are needed to understand the challenges and needs of practitioners caring for pregnant women with epilepsy. To address this, based on studies available we suggest joint (neurology and obstetrics) clinics, the availability and dissemination of guidelines, a risk evaluation tool and guidelines in the content and nature of communication with women.

Item Type: Article
Identification Number:
8 April 2024Accepted
10 April 2024Published Online
Subjects: CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-02 - medicine (non-specific)
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-04 - midwifery
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Depositing User: Judith Dyson
Date Deposited: 19 Apr 2024 11:31
Last Modified: 19 Apr 2024 11:31

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