{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:34:40Z","timestamp":1777433680195,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Australas Psychiatry"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sodium valproate\u2019s teratogenicity has prompted increasing restrictions to its use. Our initial audit 2\u00a0years prior demonstrated continuing hazardous prescription to women of childbearing age in a New Zealand psychiatric inpatient unit, consistent with nationwide dispensing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Following a service-wide educational intervention and application of \u201cblack box\u201d warnings, we conducted a follow-up audit of valproate prescription in the same inpatient unit by reviewing records of women admitted over a 10-month period (March 2020\u2013January 2021). Results were compared with local and international guidelines, and against data from our initial audit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two hundred and sixty-one women of childbearing age were admitted over the sampling period, 26 of whom (10%) were prescribed valproate on discharge. Over three quarters (77%) of these patients had diagnoses other than bipolar affective disorder, valproates only approved psychiatric indication in New Zealand. Following intervention, significant improvements were observed in several key indicators of prescribing quality: pregnancy testing, documentation of contraception status, and discussion of teratogenic risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Following intervention, re-audit demonstrated reduced prescription of valproate and improved management of its teratogenic risk in women of childbearing age receiving inpatient psychiatric care. These results demonstrate the value of a systematic approach to improve prescribing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10398562231169369","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T05:58:26Z","timestamp":1681106306000},"page":"524-527","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Brief intervention reduces prescription of sodium valproate in women of childbearing age"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2003-7893","authenticated-orcid":false,"given":"Rachel","family":"Goldspink","sequence":"first","affiliation":[{"name":"Waikato Hospital, Hamilton, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5260-0855","authenticated-orcid":false,"given":"Toni","family":"Pumipi","sequence":"additional","affiliation":[{"name":"Waikato Hospital, Hamilton, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3760-7896","authenticated-orcid":false,"given":"David B","family":"Menkes","sequence":"additional","affiliation":[{"name":"Waikato Clinical Campus, Waikato Hospital, Hamilton, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"bibr1-10398562231169369","first-page":"365","volume":"27","author":"Lemperiere T","year":"2001","journal-title":"Encephale"},{"key":"bibr2-10398562231169369","unstructured":"The Portal for Rare Diseases and Orphan Drug. Fetal valproate syndrome, Available at: http:\/\/www.orpha.net\/consor\/cgibin\/OC_Exp.php?Lng=GB&Expert=1906."},{"key":"bibr3-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2008.04.022"},{"key":"bibr4-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.176990"},{"key":"bibr5-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803531"},{"key":"bibr6-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02129.x"},{"key":"bibr7-10398562231169369","volume-title":"Supporting treatment safety 2020: using information to improve the safety of treatment","author":"Accident Compensation Corporation","year":"2020"},{"key":"bibr8-10398562231169369","volume-title":"European medicines agency: valproate and related substances"},{"key":"bibr9-10398562231169369","volume-title":"Alert communication: use of sodium valproate (Epilim) in girls and women \u2013 change to indications and contraindications","author":"New Zealand Medicines and Medical Devices Safety Authority"},{"key":"bibr10-10398562231169369","volume-title":"Alert communication: use of sodium valproate (Epilim) in girls and women \u2013 change to indications and contraindications","author":"Medsafe and"},{"key":"bibr11-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1177\/1039856220934317"},{"key":"bibr12-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.10.006"},{"key":"bibr13-10398562231169369","volume-title":"Antenatal and postnatal mental health: clinical management and service guidance [CG192]","author":"National Institute for Health and Care Excellence","year":"2014"},{"key":"bibr14-10398562231169369","volume-title":"European medicines agency: valproate and related substances"},{"key":"bibr15-10398562231169369","doi-asserted-by":"publisher","DOI":"10.1177\/0269881105053307"}],"container-title":["Australasian Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562231169369","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10398562231169369","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562231169369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:52:03Z","timestamp":1777377123000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/10398562231169369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1177\/10398562231169369"],"URL":"https:\/\/doi.org\/10.1177\/10398562231169369","relation":{},"ISSN":["1039-8562","1440-1665"],"issn-type":[{"value":"1039-8562","type":"print"},{"value":"1440-1665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,10]]}}}