Skip to Main content Skip to Navigation
Master Thesis

Évaluation de la prescription de doxylamine dans le traitement des nausées et vomissements gravidiques : enquête auprès de 752 médecins généralistes

Abstract : Context: Nausea and vomiting of pregnancy (NVP) are very common. Usually present in the first quarter, they can last throughout pregnancy. Reassure patients and the lavish lifestyle advice is sufficient in most cases but the use of drug therapy is sometimes necessary. But in France no anti emetic class is approved by health authorities regarding pregnant women. The molecule having the most favorable profile in the literature is doxylamine, recommended as first in the specific treatment of NVP in the United States and Canada. In France, it is available with the sole indication specified is the treatment of occasional insomnia in adults. Objectives: We conducted a survey to assess the prescription doxylamine by GPs. Do they know this molecule and this indication? If yes, how ? Does the use they first line? If not why ? Method: 752 GPs practicing in France responded to a semi structured questionnaire sent by email in spring 2015. Results: Only 32.8% of respondents prescribe doxylamine. 21.5% in first intention after failure of dietary measures. Women doctors and under 40 are significantly more likely to prescribe. The most cited sources of information are le CRAT site and Prescrire review. The main obstacles to prescription doxylamine in NVG are ignorance of the molecule (22.5% of non-prescribers) and / or the indication (50%), lack of AMM (21.5%) and fear of side effects for the mother (12.5%) and child (9.5%). Conclusion: Despite the absence of marketing authorization, the conditions are met to justify the prescription of doxylamine and avoid legal risk mentioned by many doctors in our survey. With efficiency and safety amply demonstrated in the literature and a major setback for use, doxylamine should be the reference drug treatment in NVP. A more developed information to prescribers who prefer molecules at least advantageous profile seems necessary.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [86 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01415031
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, December 12, 2016 - 5:33:28 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:02 PM
Long-term archiving on: : Tuesday, March 28, 2017 - 12:31:28 AM

Identifiers

  • HAL Id : dumas-01415031, version 1

Collections

Citation

Marie Bouhier de l'Écluse. Évaluation de la prescription de doxylamine dans le traitement des nausées et vomissements gravidiques : enquête auprès de 752 médecins généralistes. Médecine humaine et pathologie. 2016. ⟨dumas-01415031⟩

Share

Metrics

Record views

276

Files downloads

4045