Women surveyed about their treatment for hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy, reported delayed or missed diagnoses, inadequate clinician knowledge of treatment guidelines, denied or discontinued medicines, and structural barriers restricting access to appropriate care. The qualitative study of 189 women, published in the Journal of Pharmacy Practice and Research, found that these experiences accompanied enduring emotional and psychological effects, including anxiety and post-traumatic stress syndrome. Associate Professor Luke Grzeskowiak, who led the research team at Flinders University, said the condition affects almost 4% of pregnancies.

The survey identified several issues affecting how hyperemesis gravidarum is recognised and treated. Participants described clinicians who lacked suitable training to diagnose the condition and who were either unaware of clinical management guidelines or did not follow them. Some women said they were not diagnosed with hyperemesis gravidarum when they should have been, while others reported receiving a diagnosis only late in the course of their illness. Other participants said health professionals denied prescribing or dispensing medications. The researchers also identified educational and financial status as possible influences on treatment outcomes, together with systemic barriers within Australia’s healthcare system.

Misinformation about medicine safety further disrupted care for some participants. Some women said they stopped taking medication after reading reported safety concerns that the researchers said were not aligned with current research and management guidelines. Participants also described poor management of medication side effects, including constipation and mood disorders. Current treatment focuses on supportive care and on medicines, including antiemetics, that address nausea and vomiting. Nevertheless, women reported that their symptoms were often not taken seriously and that clinicians in several professions commonly lacked appropriate education and training to recognise and manage hyperemesis gravidarum.

The study documented emotional and psychological effects during and after the illness. Participants cited impaired quality of life, anxiety and post-traumatic stress syndrome. The researchers said some women reported that hyperemesis gravidarum influenced their decision to terminate an otherwise wanted pregnancy, while others said the trauma of a previous episode left them afraid to consider another pregnancy. Collectively, the researchers proposed improving experiences and outcomes through better education for health practitioners, greater public awareness, clearer clinical practice guidelines, expanded outpatient care, investment in specialist hyperemesis gravidarum clinics and services, changes to the Pharmaceutical Benefits Scheme, and strategies to improve medicine availability and affordability. Because the research was a qualitative survey based on reported experiences and perceptions, it does not quantify how frequently these barriers occur among all pregnancies affected by the condition.

Subject of Research: Women’s experiences of pharmacological care for hyperemesis gravidarum

Article Title: Greater access to help needed for women with nausea during pregnancy

Article References: Greater access to help needed for women with nausea during pregnancy. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: hyperemesis gravidarum, pregnancy, nausea and vomiting, antiemetic medicines, qualitative survey, clinical guidelines, healthcare access, medication safety, mental health, Greater, access, help

While the recreational use of marijuana is usually associated with a more peaceful mental state, scientists just a made a surprising discovery.

As detailed in a meta analysis of cannabis-related studies published last month in the journal Psychological Medicine, a team of scientists in the UK discovered a significant link between cannabis use and an “increased risk of violence.”

The headline finding was that they found cannabis users were statistically more likely to be the perpetrators of violent acts. They also found that the use of the drug — particularly among women and mixed-gender cohorts — was “significantly associated with an increased risk of becoming a victim of violence” as well.

While it’s a classic case of correlation, not causation — the researchers stop far short of suggesting the drug directly motivates users to be more violent as we’re far from reaching a scientific consensus on the matter — the findings “underscore the importance of addressing this issue at both a societal and clinical level,” according to the paper.

In other words, it’s a highly nuanced and complex relationship with plenty of other factors at play.

“As a clinician, I’ve seen how heavy cannabis use can be a factor in violence,” said coauthor and King’s College London professor Marta Di Forti in a statement. “We’ve been cautious for a long time about how far we could go in describing this link, but a review of this size lets us speak with more confidence about the risks, while being careful not to stigmatise people who use cannabis more broadly.”

“As cannabis becomes more commercialized and legalised around the world, the conversation about its risks has focused mostly on the person using it,” added coauthor and King’s College London professor of psychiatric research Sir Robin Murray. “This review shows that violence, both committing it and experiencing it, needs to be part of that conversation too.”

For their paper, the researchers examined 63 cannabis-related studies, involving just over 265,000 subjects.

The researchers found that cannabis users “may place themselves in risky situations,” which could help explain the “increased vulnerability” to violence. Users may also be exposed to “peers who engage in substance use or criminal activities.”

The risk of violence was also more pronounced among psychiatric patients. Previous resarch has found that people who already suffer from pre-existing mental conditions such as psychosis may experience “poorer clinical outcomes” through continued cannabis use.

“Given the higher rate of cannabis use among individuals with severe mental disorders compared to the general population, this group represents a particularly at-risk population in terms of violent behavior,” the paper reads.

The researchers offered some key takeaways from their findings. At the societal level, the researchers suggest that “violence should be considered alongside other established cannabis-related harms when developing prevention strategies, public education campaigns, and regulatory policies.”

At the clinical level, the research highlights the “necessity for mental health professionals to routinely assess cannabis use in individuals presenting with violent tendencies, particularly among those with severe mental illness.”

However, to get a better picture of how cannabis use relates to violence, future studies will need to “disentangle causal pathways” by diving into how, why, and when people use the drug in more detail. Other studies should also “examine whether reducing cannabis use through clinical or public health interventions leads to reductions in violent behavior,” the researchers conclude.

More on marijuana: Research Suggests the Older You Get, the More Weed You Should Smoke

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