Pregnant women report being denied medications to treat severe nausea and vomiting of pregnancy or hyperemesis gravidarum – findings from an Australian online survey

Hsiao, Han Fang; Thomas, Alicia; Kay-Smith, Caitlin; Grzeskowiak, Luke E.

doi:10.1111/ajo.13359

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Unfortunately, pregnancy safety categories are seldom updated post market access, 7 and sponsors may apply more restrictive pregnancy safety classifications than clinical data suggests are appropriate, 41 or include additional pregnancy caution labels that limit access further. 42 , 43 …”

Section: Resultsmentioning

confidence: 99%

How the structural determinants of health inequities impact access to prescription medication for pregnant women in Australia: a narrative review

Jackson,

Grzeskowiak,

Enticott

et al. 2024

The Lancet Regional Health - Western Pacific

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Section: Resultsmentioning

confidence: 99%

How the structural determinants of health inequities impact access to prescription medication for pregnant women in Australia: a narrative review

Jackson,

Grzeskowiak,

Enticott

et al. 2024

The Lancet Regional Health - Western Pacific

Self Cite

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“…The current lack of clinical attention, misinterpretation of symptoms, and delayed diagnosis and treatment of HG patients underlines a need to improve clinical care [ 12 ]. In a study involving an online survey of 249 patients with severe NVP or a formal diagnosis of HG, one in four were denied medications such as doxylamine to treat their condition [ 13 ]. Even when those with HG are treated with medications, the quality of evidence to support their use is slim.…”

Section: Introductionmentioning

confidence: 99%

Assessment of management approaches for hyperemesis gravidarum and nausea and vomiting of pregnancy: a retrospective questionnaire analysis

Mares

Morrow

Shumway

et al. 2022

BMC Pregnancy Childbirth

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Background Hyperemesis gravidarum is the most severe form of nausea and vomiting of pregnancy, or morning sickness. 2% of pregnancies in the United States are affected by hyperemesis gravidarum. The condition is characterized by severe vomiting in pregnant people, especially during the first trimester, often leading to hypovolemia and weight loss. The standard of care for hyperemesis and nausea and vomiting of pregnancy is commonly ineffective. We hypothesize that based on patient experience; the current treatment guidelines for hyperemesis are not clinically effective. Our objective was to identify the efficacy of the various management approaches that are currently in place for hyperemesis and nausea and vomiting of pregnancy. Methods A questionnaire was designed based on diagnostic criteria, standard demographic identifiers, and common medications for the treatment of hyperemesis gravidarum. This questionnaire was distributed online to through hyperemesis and nausea and vomiting of pregnancy support groups, personal social media, and institutional email. Results In our study, most participants diagnosed with hyperemesis gravidarum trialed at least three medications, most of which were ineffective and/or had severe side effects. The most used medication for treatment of hyperemesis gravidarum is ondansetron, a standard antiemetic, with fatigue and constipation being the most reported side effects. All data in the dataset was coded as categorical and analyzed using contingency tables using Mantel-Haenszel Chi square tests. Conclusions The data presented in this research provides insight into the suffering that patients with these diagnoses face day-to-day due to the lack of efficacious, well-tolerated treatment options. Establishing this gap in treatment can facilitate the development of effective treatments that will provide relief for thousands of patients.

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Nausea and vomiting in pregnancy: a cross-sectional study of community pharmacists in the UK

Payne,

Righton,

Nana

et al. 2024

International Journal of Pharmacy Practice

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Objectives To assess the content and frequency of advice community pharmacists (CPs) provide to pregnant women with nausea and vomiting, their confidence in providing advice, and their knowledge of the safety of medication used to manage the condition. Methods An online questionnaire of closed- and open-ended questions was distributed to CPs in the UK in May 2023. Closed-ended questions were analysed quantitatively, and conventional content analysis was utilised for open-ended responses. Key findings One hundred and eighty-one respondents completed the questionnaire, 24 responses were excluded, leaving data from 157 available for analysis. The majority (90.4%) of participants reported having experience in providing advice on nausea and vomiting with varying levels of confidence. Advice provided included using over-the-counter products, lifestyle modifications, reassurance, medication advice, and referring to other healthcare professionals. Knowledge of first-line antiemetics considered safe in pregnancy varied; cyclizine was correctly identified as safe during pregnancy by 57.3%, followed by 37.6% for promethazine and 31.2% for prochlorperazine. Self-reported confidence and having experience providing advice were related to higher medication safety identification rates. Five percent of participants reported previous training on the condition, while 70% reported wanting further education, preferably delivered via an online medium. Conclusions This study showed that although 90% of CPs provide advice on nausea and vomiting in pregnancy, their medication safety knowledge varied. The majority of CPs reported wanting further education that would ensure women could access reliable information and evidence-based advice to optimise management of the condition.

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Pregnant women report being denied medications to treat severe nausea and vomiting of pregnancy or hyperemesis gravidarum – findings from an Australian online survey

Cited by 5 publications

References 14 publications

How the structural determinants of health inequities impact access to prescription medication for pregnant women in Australia: a narrative review

How the structural determinants of health inequities impact access to prescription medication for pregnant women in Australia: a narrative review

Assessment of management approaches for hyperemesis gravidarum and nausea and vomiting of pregnancy: a retrospective questionnaire analysis

Nausea and vomiting in pregnancy: a cross-sectional study of community pharmacists in the UK

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