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Non-medical midwifery prescribing of an antiemetic for a glucose tolerance test: a case study

02 November 2022
Clinical Focus
02 November 2022
Volume 4 · Issue 11

Abstract

This is a case study of a 26-week pregnant woman requiring an antiemetic before a glucose tolerance test and the prescribing decision that a non-medical midwifery prescriber needed to make in the outpatient setting. The case study demonstrates how the prescriber demonstrated the Royal Pharmaceutical Society competencies. The Calgary-Cambridge model was used to assess the patient. There are no local or national guidelines for this situation with very limited evidence available to assess the effectiveness of the different antiemetics. The consultant's advice in the local setting is to prescribe a cyclizine 50mg tablet. This case study evaluates the available evidence and guidelines and concludes that prescribing cyclizine in this scenario is reasonable in the absence of any good evidence.

This is a case study of a 26-week pregnant woman, pseudonym Saafia, who required an antiemetic prior to commencing a glucose tolerance test (GTT) in an outpatient setting. A GTT requires the woman to drink a sugary drink to test for gestational diabetes (Royal College of Obstetricians and Gynaecologists (RCOG), 2011). Saafia had attempted a GTT previously but had been unable to complete it as she vomited the drink after ingestion. This article will consider the different prescribing options available to a non-medical midwifery prescriber working in this outpatient setting. The Calgary-Cambridge consultation model was used to assess the patient and to reach a shared prescribing decision. It is part of the Nursing and Midwifery Council (NMC) code that midwives should practise safely by prescribing within the limits of their competency (NMC, 2018) and the NMC has adopted the Royal Pharmaceutical Society (RPS) competency framework (NMC, 2019). It is demonstrated throughout the article how the prescriber demonstrated these competencies in this case.

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Antiemetic
Calgary-Cambridge consultation model
glucose tolerance test
pregnancy
nausea and vomiting
competencies for prescribers