{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:27:54Z","timestamp":1773268074564,"version":"3.50.1"},"reference-count":103,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015846","name":"Llywodraeth Cymru","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015846","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015846","name":"Llywodraeth Cymru","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015846","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Valproate is a highly effective antiseizure medication but carries significant teratogenic and neurodevelopmental risks to offspring if used during pregnancy. A shared decision\u2010making (SDM) approach is recommended to guide clinician\/patient discussions on valproate suitability for women with pregnancy potential. This study applied the Capability, Opportunity, Motivation\u2013Behaviour (COM\u2010B) theoretical framework to explore barriers and facilitators to SDM in valproate prescribing from the perspectives of women with epilepsy who have pregnancy potential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative study using timeline\u2010facilitated semi\u2010structured interviews informed by the COM\u2010B model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Twelve UK\u2010based women 18\u201350\u2009years (M\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200933.3, SD\u2009=\u20097.59) prescribed valproate were recruited via pharmacies and epilepsy organizations' social media. Interviews were thematically analysed and interpreted using the COM\u2010B model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were highly motivated to engage in SDM behaviour but reported limited opportunities. Challenges to COM\u2010B domains included insufficient information exchange, low confidence navigating complex epilepsy\/reproductive health care discussions, and tensions navigating valproate risks and benefits within broader contexts of seizure control and reproductive health. Initial prescribing during acute seizure crises may have precluded meaningful collaborative discussion. Valproate prescribing\/deprescribing incongruent to reproductive goals often resulted in deep regret and deleterious health outcomes for women (and children exposed to valproate in utero).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Comprehensive SDM when valproate is considered clinically appropriate could support informed, patient\u2010centred decision\u2010making. Equipping clinicians to navigate multifaceted risk\/benefit discussions and empowering patients with clear, tailored information can help ensure treatment decisions align with reproductive goals. This study highlights the need to embed SDM in valproate prescribing consultations and throughout treatment duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.70045","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T05:40:37Z","timestamp":1766209237000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Capability, opportunity and motivation for shared decision\u2010making about valproate as an antiseizure medication treatment for epilepsy in women with pregnancy potential: A qualitative study of patient perspectives"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0236-7268","authenticated-orcid":false,"given":"Sarah Louise","family":"Griffiths","sequence":"first","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University  Cardiff UK"},{"name":"Department of Pharmacology and Therapeutics, Institute of Systems, Molecular, and Integrative Biology University of Liverpool  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delyth","family":"James","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University  Cardiff UK"},{"name":"School of Medicine Swansea University  Swansea UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denitza","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Population Medicine, School of Medicine Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynette","family":"James","sequence":"additional","affiliation":[{"name":"Cardiff and Vale University Health Board  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Evans","sequence":"additional","affiliation":[{"name":"Health and Social Services Group Welsh Government  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William O.","family":"Pickrell","sequence":"additional","affiliation":[{"name":"School of Medicine Swansea University  Swansea UK"},{"name":"Swansea Bay University Health Board  Swansea UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5007-9296","authenticated-orcid":false,"given":"Christine","family":"McKnight","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Brown","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4256-4598","authenticated-orcid":false,"given":"Rhiannon","family":"Phillips","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"e_1_2_16_2_1","unstructured":"All Wales Therapeutics and Toxicology Centre. 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