Endocrine Abstracts

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is contraindicated during pregnancy, because of teratogenicity concerns and observations of foetal adverse effects in animal studies. The National Institute for Health and Care Excellence recommends avoidance in pregnancy and contraception use in women of childbearing potential. Thus, providing and documenting appropriate counselling on contraception use and pregnancy avoidance for females of childbearing age, prior to initiating therapy is crucial. We sought to evaluate the documentation of contraceptive advice and pregnancy avoidance counselling in dictated clinic letters regarding women aged 15 to 55 years, prior to GLP-1 RA initiation. Dictated letters between 28th October to 10th November 2024 from the obesity new referral clinics in Galway University Hospital were audited. Data was collected and analyzed using Microsoft Excel. Of 33 patients who attended, 19 were female and 16 (84.2%) of these were of childbearing age. Eight (50%) of these patients were prescribed GLP-1 RA, five (31.2%) were already on them, and three (18.8%) declined pharmacotherapy. Documentation of contraceptive advice was found in two (12.5%) dictated letters, and pregnancy avoidance counselling in five (31.3%). This audit provides evidence of inadequate documentation of essential reproductive counselling to patients with obesity prior to GLP-1 RA initiation. Whether appropriate counselling was provided but not documented, or patients are not adequately counselled remains to be determined. Strategies to mitigate this potential risk, including educational sessions for doctors and emphasizing the importance of complete documentation may help. A re-audit is planned to assess the impact of these interventions.