Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Use, experiences and perceptions of medicines for treating severe nausea and vomiting of pregnancy or hyperemesis gravidarum: an Australian consumer survey (#104)

Loyola Wills 1 , Han-Fang Hsiao 2 , Alicia E Thomas 2 , Caitlin Kay-Smith 3 , Amanda Henry 4 5 , Luke E Grzeskowiak 1 2 6 7
  1. Flinders University, Adelaide, South Australia, Australia
  2. SA Pharmacy, Flinders Medical Centre, SA Health, Adelaide, South Australia, Australia
  3. Hyperemesis Australia, Sydney, New South Wales, Australia
  4. University of New South Wales, Sydney, New South Wales, Australia
  5. St George Hospital, Sydney, New South Wales, Australia
  6. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  7. Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia

Background: There is little data on contemporary patterns of antiemetic use or women’s experiences when using such agents in the treatment of severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG).

Methods: Online, national survey of Australian women who are currently or have previously experienced severe NVP or HG, distributed through the HG consumer group, Hyperemesis Australia between July and September 2020.

Results: There were a total of 326 respondents with a mean age of 33, of which 39% were currently pregnant. The most commonly used anti-emetic was ondansetron (81%), followed by pyridoxine (62%), doxylamine (62%), and metoclopramide (62%). Nearly all (95%) women who reported using ondansetron commenced it within the first trimester. More than half of respondents reported using ondansetron first-line. Most women reported one or more side effects to anti-emetics, with 1 in 3 women stopping metoclopramide because of side effects, compared with 15% for ondansetron and 11% for doxylamine. When rating perceived effectiveness on a Likert scale of 1 (being not very effective) to 5 (being very effective), ondansetron (mean 3.8 ± 1.0 standard deviation), corticosteroids (3.8 ± 1.3) and doxylamine (3.6 ± 1.2) were rated much higher than metoclopramide (2.3 ± 1.2). In assessing attitudes towards medication use during pregnancy, while the vast majority of women (77%) agreed that it is better for the fetus to use medicines and get well than to have an untreated illness, 44% mentioned using less medicine than needed due to being pregnant. Notably, nearly half (46%) respondents said that they had heard of the SOMANZ guidelines for treating NVP/HG (mainly through online support groups), with 56% saying that they reassured them of the safety of medicines.

Conclusions: The study findings demonstrate large variability in antiemetic use during pregnancy, with ondansetron appearing to be increasingly utilised as first-line agent.