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. 2023 Aug 11:14:1232871.
doi: 10.3389/fpsyg.2023.1232871. eCollection 2023.

It's a helluva journey: a qualitative study of patient and clinician experiences of nausea and vomiting syndromes

Gabrielle Sebaratnam  1 , Mikaela Law  1   2 , Elizabeth Broadbent  3 , Armen A Gharibans  1   2 , Christopher N Andrews  1   4 , Charlotte Daker  5 , Greg O'Grady  1   2 , Stefan Calder  1   2 , Celia Keane  2   6
Affiliations

It's a helluva journey: a qualitative study of patient and clinician experiences of nausea and vomiting syndromes

Gabrielle Sebaratnam et al. Front Psychol. .

Abstract

Background: Chronic gastroduodenal disorders including, chronic nausea and vomiting syndrome, gastroparesis, and functional dyspepsia, are challenging to diagnose and manage. The diagnostic and treatment pathways for these disorders are complex, costly and overlap substantially; however, experiences of this pathway have not been thoroughly investigated. This study therefore aimed to explore clinician and patient perspectives on the current clinical pathway.

Methods: Semi-structured interviews were conducted between June 2020 and June 2022 with 11 patients with chronic nausea and vomiting syndrome alone (based on Rome IV criteria) and nine gastroenterologists who treat these conditions. Interviews were recorded, transcribed, and thematically analyzed using a reflexive, iterative, inductive approach. Five key patient themes were identified: (1) the impacts of their chronic gastroduodenal symptoms, (2) the complexity of the clinical journey, (3) their interactions with healthcare providers, (4) the need for advocacy, and (5) their experience of treatments. Five key clinician themes were also identified: (1) these conditions were seen as clinically complex, (2) there is an uncertain and variable clinical pathway, (3) the nuance of investigations, (4) these conditions were difficult to therapeutically manage, and (5) there are barriers to developing a therapeutic relationship.

Conclusion: Findings indicate that both patients and clinicians are dissatisfied with the current clinical care pathways for nausea and vomiting syndromes. Recommendations included the development of more clinically relevant and discriminant tests, standardization of the diagnostic journey, and the adoption of a multidisciplinary approach to diagnosis and treatment.

Keywords: chronic nausea and vomiting syndrome; clinical care pathways; disorders of gut-brain interaction; functional gastrointestinal disorders; gastroparesis; healthcare utilization; interview.

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Conflict of interest statement

GO’G and AG hold grants and intellectual property in the field of gastrointestinal electrophysiology and are Directors in Alimetry Ltd. GO’G is a Director in The Insides Company and CK is a medical advisor for The Insides Company. GS, ML, SC, CA, and CD are members of Alimetry Ltd. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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