title: Epilepsy and AED-induced decreased libido - The unasked psychosocial comorbidity.
abstract: Therapeutic treatment for persons with epilepsy (PWE) should address seizure control and the broad spectrum of associated comorbidities. Since both epilepsy and antiepileptic drugs (AEDs) can induce decreased libido, sexual health assessment is an important aspect of quality care in PWE as well as other patients receiving AEDs. This paper presents findings from a pilot quality initiative conducted in the ambulatory care epilepsy, pain management, and psychiatric services (N=15 clinicians) which addressed two themes: 1) whether libido is routinely questioned with/without the electronic medical record (EMR) and 2) clinicians' knowledge that both epilepsy and AEDs can induce decreased libido. All clinicians used the EMR, 40% used the GU-ROS section, but only 1 clinician (6.67%) questioned patients regarding libido. Of the clinicians, 26.7% demonstrated knowledge that both AEDs and epilepsy can cause decreased libido. Our results suggest that a treatment gap for epilepsy-induced and AED-induced decreased libido may be related to systems issues (duration of clinical visit, billing codes, EMR template) and physician barriers including decreased knowledge. Further research in this field and replication of this pilot quality initiative are indicated.
authors.affiliation: Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Department of Anesthesiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. Electronic address: kaufmakr@rwjms.rutgers.edu.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Kaufman
authors.affiliation: Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Kartik
authors.initials: K
authors.lastname: Sivaraaman
authors.affiliation: Department of Anesthesiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Candy
authors.initials: C
authors.lastname: Anim
authors.affiliation: Department of Anesthesiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: David
authors.initials: D
authors.lastname: Delatte
mesh_terms: D000554:Ambulatory Care Facilities; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D015897:Comorbidity; D057286:Electronic Health Records; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007989:Libido / Q000187:drug effects*; D010865:Pilot Projects; D058996:Quality Improvement
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Clinical practice barriers; Education and training; Electronic medical record (EMR); Epilepsy; Libido; Pain management; Psychiatry; Psychosocial comorbidities; Quality of life; Treatment gap