Acupuncture treatment for hyperemesis gravidarum: A modified Delphi consensus study
By Sarah Budd - Online MSc - Advanced Oriental Medicine
Abstract
Background
Hyperemesis Gravidarum (HG) is a serious, potentially life-threatening condition of pregnancy involving severe vomiting, dehydration and weight loss. Limited evidence suggests acupuncture may be an effective treatment. Studies to date have questionable methodologies. There is currently no standard acupuncture protocol for the treatment of HG with acupuncture.
Aims and objectives
The aim: to ascertain which acupuncture treatment approaches are thought to be most effective and generally agreed amongst a group of experienced practitioners.
The objective: to see if consensus can be reached in order to inform good clinical practice and future research studies.
Methodology
A modified Delphi consensus study using mixed methods. This was administered by email and online via Survey Monkey. Nineteen international acupuncturists with experience in treating HG participated in three rounds of Delphi questionnaires. The first two rounds collected quantitative data on acupuncture for HG. An opportunity to add comments provided qualitative data. Round three comprised a summary of the previous two rounds, with thematic analysis of the qualitative data, and an invitation for further comments. Consensus was defined as a mean of five or more on a seven point Likert scale.
Findings
Agreement was reached on the most effective acupuncture points and treatment approaches. Through comments made in all rounds, study participants confirmed the importance of issues such as safety, technique, practicality and wider treatment approaches. Practical advice relating to these themes was shared by participants.
Conclusion
Although there are few good quality studies on acupuncture for HG, a consensus amongst experienced practitioners of Traditional Chinese Medicine (TCM) on best practice for this distressing condition of pregnancy was possible. This could be used in the development of protocols, and contribute to the improved design of future research studies. It could also offer guidance for clinical practice, and in advising policy stakeholders.
