Luki w opiece zdrowotnej dziewczyn nastolatków z epilepsją: badanie retrospektywne dotyczące zdrowia rozrodczego i psychicznego
Identifying care gaps in female adolescent reproductive and mental health within epilepsy clinics: a single-center retrospective study
W skrócie
Badanie wykazało, że dziewczyny nastoletnie z epilepsją nie otrzymują wystarczającej porady dotyczącej antykoncepcji i suplementacji kwasem foliowym - tylko około 17% pacjentek rozmawiało o tych tematach z lekarzem. Badacze stwierdzili również, że problemy psychiczne u tych dziewczyn nie są dostatecznie dokumentowane w szpitalnych rejestrach medycznych. Rezultaty pokazują poważne braki w przestrzeganiu wytycznych dotyczących zdrowia rozrodczego i psychicznego w klinikach neurologicznych zajmujących się dziewczętami z epilepsją.
Oryginalny abstract (angielski)
AIM: To analyze the reproductive and mental health status of reproductive-age youth with epilepsy (RAYE) and highlight gaps in reproductive and mental health counseling for this population. METHODS: This retrospective study included 518 RAYE (10-18 years) referred to the University of Alberta Pediatric Comprehensive Epilepsy Program and seen in pediatric neurology clinics in Edmonton between January 2015 to November 2019, and July 2021 to July 2022. The primary outcome was documentation of reproductive health counselling in the clinical charts. Secondary outcomes included the frequency and nature of the mental health comorbidities documented in the clinical charts and mental health diagnoses recorded as ICD-10 codes in the health system database. RESULTS: Contraceptive counseling was discussed with 17.0% of patients and folic acid supplementation with 16.8% of patients. There was reasonable agreement between clinical chart documentation (55%) and the health system database (56.4%) in identifying patients with documented mental health comorbidities. However, the health system database contained a wider range of ICD-recorded diagnoses, so chart records may not fully capture the quality and quantity of mental health comorbidities when they are present. CONCLUSION: This study highlights critical gaps in adherence to reproductive and mental health counselling guidelines within ambulatory neurology clinics for RAYE. Patients are not receiving adequate reproductive health guidance, and mental health comorbidities remain insufficiently captured in clinical documentation, factors that collectively undermine the standard of care provided to this population.