Australian Healthcare Professionals Research Articles

Perspectives of Australian healthcare professionals towards gamification in practice.

Gamification may be an effective tool in motivating sustained behaviour change. This study aimed to explore perspectives of Australian-based healthcare professionals, including dietitians, towards gamification in their practice when assisting patients/clients to achieve health-related goals. Semi-structured online interviews were conducted with healthcare professionals. Data was audio-recorded, transcribed verbatim, de-identified and thematically analysed to identify key themes and inform the creation of personas. Six dietitians, two psychologists, two exercise physiologists, one medical specialist, with 1-24 years of work experience, participated. Most participants (n = 7, 64%) were unable to articulate a definition of gamification, however, when offered more context, they could identify examples. Overall, participants were positive towards gamification, regardless of prior experience/exposure. Three themes emerged; (1) Variable familiarity with gamification, (2) Context matters, (3) Barriers hinder engagement/adoption. Stage of career rather than profession influenced participants' views of gamification, as reflected in three characterising personas; 'Joel: Early-Career, Progressive', 'Bella: Mid-Career, Stable' and 'Sam: Advanced-Career, Expert'. Findings suggest that gamification is not widely used in health practice in Australia. Concerns about participation costs and data privacy are adoption barriers. Promotion of the effectiveness of gamification as a valuable adjunct tool to encourage behaviour change needs support from peak bodies. Embedding gamification in university curricula could better prepare graduates to engage with gamification in future practice. Further research capturing more diverse healthcare professionals' perspectives is required to fully understand the potential of gamification to change health behaviours, and to design feasible gamified solutions.

Healthcare professionals' perceptions of hypnotherapy in cancer care: Development and validation of a survey

Background and purposeHypnotherapy has shown promise in cancer care for alleviating pain, managing nausea, reducing anxiety and fatigue, and improving overall quality of life. Despite its potential benefits, there remains a significant gap between evidence and clinical practice. One way to bridge this gap is to assess healthcare professionals' perceptions and address them accordingly. While survey tools assessing perceptions in healthcare exist, they often are outdated, lack contemporary focus and specificity to complementary therapies like hypnotherapy, particularly in the context of cancer care. This study aimed to develop, psychometrically evaluate, and pilot a survey designed to assess Australian healthcare professionals' (psychologists, counselors, medical practitioners, and nurses) perceptions of hypnotherapy in cancer care. Materials and methodsA cross-sectional survey was developed to assess healthcare professionals' perceptions of hypnosis/hypnotherapy in cancer care. The survey, informed by a comprehensive literature review, consisted of three sections: (1) demographics, 2) interest, experience and knowledge of hypnosis, and (3) attitudes towards its integration in cancer care. Instrument validation involved an expert panel (n = 5) review for content validity and a pilot study with 89 healthcare professionals for reliability. Internal consistency was measured using Cronbach's alpha and factor analysis. ResultsPsychometric analysis demonstrated high internal consistency with a Cronbach's alpha of 0.850. Factor analysis revealed two distinct factors: perceived benefits of hypnotherapy in cancer care (explaining 49.23 % of variance) and concerns/misconceptions about hypnosis (explaining 19.50 % of variance). These factors showed strong item loadings (0.692–0.889 and 0.529-0.850, respectively) and a moderate correlation (r = 0.464). The survey tool proved feasible and applicable with a high completion rate among participants. The survey pilot results highlighted significant knowledge gaps and varying levels of acceptance of hypnotherapy, underscoring the necessity for targeted education and training initiatives. Despite these gaps, there was a notable interest in learning more about hypnotherapy's potential benefits in cancer care. However, limitations to sample diversity and generalizability should be noted, as the vast majority of respondents were female nurses. ConclusionA novel survey tool to evaluate healthcare professionals' perceptions of hypnotherapy in cancer care was developed and tested for its validity and reliability. Results of this study revealed significant knowledge gaps and varied acceptance levels by healthcare professionals to using hypnotherapy in cancer care. We identified respondents have a strong interest in hypnotherapy's potential benefits, highlighting the need for targeted education and suggesting a promising foundation for its future integration into holistic and patient-centered cancer care.

Australian Healthcare Professionals are Interested in Using Genetics to Inform Personalised Nutrition Intervention for Their Patients Living With Cardiovascular Disease

Australian Healthcare Professionals are Interested in Using Genetics to Inform Personalised Nutrition Intervention for Their Patients Living With Cardiovascular Disease

HIV associated neurocognitive disorder screening and diagnosis pathways in Australia: a scoping review and international implications

ABSTRACT Symptomatic HIV-associated neurocognitive disorder (HAND) is a complication of HIV (cognitive impairment, difficulties with everyday functioning). If detected early, interventions assist with optimizing care, avoiding rapid decline and enhancing coping. There remains inconsistency surrounding screening/diagnosis information within Australian healthcare professionals and community settings. A scoping review of academic literature, government policies and non-government organisations (NGOs) was conducted to map existing screening/diagnosis information using the guidelines of Joanna Briggs Institute. A literature search of EBSCOhost and Medline (dates: 2015–2021), the Australian government NGO web domains, Google and unpublished academic works was conducted (July 2021) and updated (December 2022) to identify Australian items (past 5 years). Seventeen items met the inclusion criteria. No government guidelines were identified. Various HIV-related organisations proposed different diagnostic guidelines. Most HAND research originated in Sydney. The most accessible information was from Dementia Australia, with some inaccuracies noted. There is scant Australian research/information on HAND screening/diagnosis. HAND translational research and screening/diagnosis standards are urgently needed to inform best practices. The Australian context is used to discuss international implications regarding higher-income countries with similar patterns/healthcare.

The salience of genomic information to reproductive autonomy: Australian healthcare professionals’ views on a changing prenatal testing landscape

Genomic testing in prenatal care is rapidly advancing and it is now possible to obtain an entire fetal genome via a blood test administered in early pregnancy. In the pursuit of reproductive autonomy, more tests are being offered to more people, for an ever-increasing range of indications. Health professionals who provide pregnancy care are at the vanguard of prenatal testing, yet their views on the impact of technology advancements remain under-explored. Qualitative interviews with Australian healthcare professionals revealed that they value prenatal testing for its information-giving potential. However, the rationale underpinning testing reveals a tension between professionals’ desire for certainty and patients’ expectation that they will be reassured. Coupled with the greater salience of genomic information over other forms of knowledge in prenatal care, we suggest that the unchecked pursuit of information by way of genomic technologies in prenatal testing may paradoxically constrain reproductive autonomy in practice.

The role of multidisciplinary MS care teams in supporting lifestyle behaviour changes to optimise brain health among people living with MS: A qualitative exploration of clinician perspectives.

Healthcare professionals have an important role in advocating for the adoption of a brain-healthy lifestyle for optimal multiple sclerosis (MS) care. Nonetheless, studies to date have mainly focussed on the consumer perspective. Herein, we aimed to explore the current practices of how healthcare professionals support protective, lifestyle-related behaviour changes to optimise brain health among people living with MS (plwMS), and their perspectives of professional roles. Australian healthcare professionals were recruited via study advertisements, purposive and snowball sampling, to participate in an online, semi-structured and audio-recorded interview. Clinicians were eligible if they had a minimum of a tertiary Bachelor's degree and 12-months experience working with plwMS, access to the Internet and sufficient time to participant. An inductive, data-driven form of reflexive thematic analysis was undertaken before thematic categorisation of the quotes from transcripts. Data analysis was guided by the methods of Braun and Clark and the study's underpinnings drew on the constructs of the Social Cognitive Theory (SCT). Six physicians, 10 MS nurses, 18 allied health professionals, one exercise therapist and one alternative therapist were interviewed. Three primary themes encompassing the perceived role of healthcare professionals in supporting a brain-healthy lifestyle were identified: (1) the empowering role, (2) collaborative role and (3) communicative role. External factors/forces including time constraints, professional expertise, training and skill set, power dynamics, consumer readiness, health literacy, self-efficacy and motivation are at play, and affect how/when healthcare professionals may support behaviour change to optimise lifelong brain health for plwMS. Healthcare professionals recognise their critical role in encouraging and supporting the adoption of a brain-healthy lifestyle to optimise lifelong brain health for plwMS. However, discord is evident when they underestimate the complexity of translating knowledge of lifestyle-related behaviour change(s) into action. Greater awareness must be made in recognising and addressing the bidirectionality of external factors such as those in the SCT, that may influence how behaviour change occurs. Healthcare professionals volunteered to be interviewed as part of the data collection phase of this study.

A mixed-methods study on the pharmacological management of pain in Australian and Japanese nursing homes.

Understanding how analgesics are used in different countries can inform initiatives to improve the pharmacological management of pain in nursing homes. To compare patterns of analgesic use among Australian and Japanese nursing home residents; and explore Australian and Japanese healthcare professionals' perspectives on analgesic use. Part one involved a cross-sectional comparison among residents from 12 nursing homes in South Australia (N = 550) in 2019 and four nursing homes in Tokyo (N = 333) in 2020. Part two involved three focus groups with Australian and Japanese healthcare professionals (N = 16) in 2023. Qualitative data were deductively content analysed using the World Health Organization six-step Guide to Good Prescribing. Australian and Japanese residents were similar in age (median: 89 vs 87) and sex (female: 73% vs 73%). Overall, 74% of Australian and 11% of Japanese residents used regular oral acetaminophen, non-steroidal anti-inflammatory drugs or opioids. Australian and Japanese healthcare professionals described individualising pain management and the first-line use of acetaminophen. Australian participants described their therapeutic goal was to alleviate pain and reported analgesics were often prescribed on a regular basis. Japanese participants described their therapeutic goal was to minimise impacts of pain on daily activities and reported analgesics were often prescribed for short-term durations, corresponding to episodes of pain. Japanese participants described regulations that limit opioid use for non-cancer pain in nursing homes. Analgesic use is more prevalent in Australian than Japanese nursing homes. Differences in therapeutic goals, culture, analgesic regulations and treatment durations may contribute to this apparent difference.

Australian healthcare professionals' beliefs and practice behaviours in management of chronic pelvic pain: a cross-sectional survey.

Background Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results Complete data were obtained and analysed from 446 respondents including gynaecologists (n =75), general practitioners (GPs) (n =184) and physiotherapists (n =187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition.

Responding to the AMR threat: data and information needs of stakeholders working in regional and remote Australia.

Our qualitative analysis of interviews with remote Australian healthcare professionals found that they require reliable, local antimicrobial resistance (AMR) data reflecting the geographical diversity of the population they serve. The optimal use of AMR data must consider challenges within this setting, including high staff turnover, limited diagnostic capacity, and antibiotic shortages.

Healthcare professionals' experiences and perceptions of artificial intelligence in regional and rural health districts in Australia.

A greater understanding of Australian healthcare professionals' perceptions of artificial intelligence (AI) is needed to identify the challenges ahead as this new technology finds its way into healthcare delivery. The aim of this study was to identify healthcare professionals' perceptions of AI, their understanding of this technology, their education needs and barriers they perceived to its implementation. Healthcare professionals in eight local health districts in New South Wales Australia were surveyed using the Shinners Artificial Intelligence Perception (SHAIP) tool. The study surveyed 176 participants from regional (59.5%), rural (36.4%) and metropolitan (4.0%) healthcare districts in Australia. Only 27% of all participants stated they are currently using AI in the delivery of care. The study found that Age, Discipline, Use of AI and Desire for Education had a significant effect on perceptions of AI, and that overall healthcare professionals believe AI will impact their role and they do not feel prepared for its use. The study showed that understanding of AI is varied and workforce knowledge is seen as the greatest barrier to implementation. More than 75% of healthcare professionals desire education about AI, its application and ethical implications to the delivery of care. The development of education is needed urgently to prepare healthcare professionals for the implementation of AI.

Availability and accessibility of services to address financial toxicity described by Australian lung cancer patients and healthcare professionals

PurposeAlthough the financial burden and impact of a cancer diagnosis has been widely described in international literature, less understood is the availability and accessibility of services to ameliorate this need. This study reports the experiences of Australian lung cancer patients and health professionals delivering care, regarding factors that exacerbate and mitigate financial stress, and availability and accessibility of services to support people following a cancer diagnosis.MethodsQualitative semi-structured interviews with twenty-three lung cancer patients attending two metropolitan tertiary health services and eleven health professionals delivering care were undertaken during July–August 2021.ResultsNeither health service systematically screened for financial toxicity nor routinely provided information regarding potential financial impacts during consultations. Patients experienced lengthy delays in accessing welfare supports, provoking financial stress and worry. Health professionals reported limited resources and referral services to support patients with financial need; this was especially problematic for patients with lung cancer. They described its psychological impact on patients and their family members or carers and warned of its impact on ability to adhere to treatment.ConclusionAvailable and accessibility of services addressing financial toxicity in Australian lung cancer patients is inadequate. Although financial stress is a common, distressing problem, health professionals feel hampered in their ability to help due to limited service availability. Left unaddressed, financial toxicity can impact treatment adherence, directly influencing health outcomes, and increase risk of poverty, amplifying social inequities. Findings highlight opportunity for actionable interventions like financial consent and routine screening and discussion of financial toxicity across care pathways.

Australian healthcare professionals' perspectives on genetic counseling and genetic diagnosis in vascular anomalies.

Genomic technologies are now utilized for the genetic diagnosis of vascular anomalies. This provides the opportunity for genetic counselors to make a significant contribution to patient care for this complex disease. The aim of this study was to explore Australian healthcare professionals' perspectives on the relatively recent integration of molecular diagnostic testing for vascular anomalies, with or without genetic counseling support. Nine semi-structured interviews were conducted with Australian healthcare professionals involved in the provision of care for individuals with vascular anomalies. Thematic analysis identified six themes: (1) Molecular diagnosis is beneficial; (2) psychosocial needs can motivate families to pursue a molecular diagnosis; (3) molecular genetic testing for vascular anomalies is complex; (4) genetic service provision is not a one size fits all; (5) a client-centered approach for genetic service provision can go a long way; and (6) the value of genetic counselors. Based on our findings, implementation of a vascular anomalies genetic diagnostic program inclusive of genetic counseling may be challenging, yet such programs are likely to benefit both patients and their families, as well as healthcare professionals. As this paradigm shift unfolds, genetic counselors have an opportunity to contribute to the vascular anomaly field by educating healthcare professionals and patients, by participating in multidisciplinary clinics to support complex cases and by raising awareness regarding their practice and potential contributions.

Challenges and solutions to cancer-related financial toxicity according to Australian health professionals: qualitative results from a national survey

PurposeTo qualitatively explore Australian healthcare professionals’ perspectives on how to improve the care and management of cancer-related financial toxicity, including relevant practices, services, and unmet needs.MethodsWe invited healthcare professionals (HCP) who currently provide care to people with cancer within their role to complete an online survey, which was distributed via the networks of Australian clinical oncology professional associations/organisations. The survey was developed by the Clinical Oncology Society of Australia’s Financial Toxicity Working Group and contained 12 open-ended items which we analysed using descriptive content analysis and NVivo software.ResultsHCPs (n = 277) believed that identifying and addressing financial concerns within routine cancer care was important and most believed this to be the responsibility of all HCP involved in the patient’s care. However, financial toxicity was viewed as a “blind spot” within a medical model of healthcare, with a lack of services, resources, and training identified as barriers to care. Social workers reported assessment and advocacy were part of their role, but many reported lacking formal training and understanding of financial complexities/laws. HCPs reported positive attitudes towards transparent discussions of costs and actioning cost-reduction strategies within their control, but feelings of helplessness when they perceived no solution was available.ConclusionIdentifying financial needs and providing transparent information about cancer-related costs was viewed as a cross-disciplinary responsibility, however, a lack of training and services limited the provision of support. Increased cancer-specific financial counselling and advocacy, via dedicated roles or developing HCPs’ skills, is urgently needed within the healthcare system.

Access to psychosocial support for people with brain tumor and family members: Healthcare professional perspectives.

Ongoing access to psychosocial support is important to maintain the well-being of people with brain tumor (PwBT) and their families; yet, there is limited knowledge of psychosocial care access. This qualitative study aimed to develop an understanding of psychosocial support pathways specific to PwBT from the perspectives of Australian healthcare professionals. Semi-structured interviews were conducted with 21 healthcare professionals working in hospital and community services supporting PwBT and their family members. Transcribed interviews were coded and analyzed thematically. The three major themes identified were: (1) Challenges in fitting people into the care system within existing pathways; (2) Benefits of longer-term care coordination and interdisciplinary connections; and (3) Brain tumor affects the whole family. Despite established psychosocial care pathways, service access varied and lacked continuity for individuals with lower-grade glioma and benign tumors across the illness trajectory. Healthcare professionals recognize the need for improved access to care coordination and multidisciplinary psychosocial care tailored to the varying needs of PwBT and their families.

Telehealth use in Australian primary healthcare during COVID-19: a cross-sectional descriptive survey

ObjectiveThis study aimed to investigate Australian primary healthcare professionals’ experiences of the rapid upscaling of telehealth during COVID-19.DesignA cross-sectional survey.Participants and settingTwo hundred and seventeen general practitioners, nurses and allied...

Australian healthcare professionals' perspectives on the ethical and practical issues associated with genomic newborn screening.

Newborn bloodspot screening (NBS) is a successful public health initiative that seeks to identify serious, treatable medical conditions. The increasing use of genomic sequencing (GS) in a wide range of medical settings has reignited the discussion on whether GS can and should be integrated into NBS. Yet, the perspectives of healthcare professionals (HCPs) in Australia on the ethical and practical issues associated with the implementation of genomic newborn screening (GNBS) are underexplored. To address this, we conducted semi-structured interviews with 16 Australian HCPs with clinical or policy experience in NBS and/or GS to explore their perspectives on the ethical, social, and practical issues raised by integrating GS into NBS. Interviews were analyzed using inductive content analysis. When asked whether GS should be incorporated into NBS, HCPs did not feel it was currently appropriate but there was a strong consensus it may be implemented within the next decade. However, HCPs had differing perspectives on what conditions should be included and how to best handle the volume of data generated from GNBS. Our findings have important implications for determining at what point and how genomics can be integrated into NBS. The differing views expressed amongst HCPs suggest that further research is needed to explore the reasons behind this. Importantly, our participants highlighted a potential role for genetic counselors in the implementation of GNBS on a larger scale by developing educational resources to facilitate obtaining informed consent and return of results.

A cross-sectional survey of Australian healthcare professionals' confidence, evidence-based knowledge and guideline use for antenatal asthma management.

Asthma is one of the most common chronic health conditions experienced during pregnancy and is associated with numerous adverse maternal and perinatal outcomes. To better understand the confidence, evidence-based knowledge and guideline use among healthcare professionals around Australia commonly involved in providing antenatal care for women with asthma. An online, cross-sectional survey was developed and distributed to maternity carers (obstetricians and midwives), primary carers (general practitioners and general practice nurses) and respiratory specialists (respiratory physicians and respiratory nurses). Self-reported confidence and use of clinical guidelines were recorded. Evidence-based knowledge was assessed with 13 questions relating to four clinical scenarios that covered recommendations from national and international guidelines. Primary carers and respiratory specialists were more confident in providing antenatal asthma care, more likely to use clinical guidelines and scored significantly higher in evidence-based knowledge of antenatal asthma management than maternity carers (P < 0.01 and P < 0.001, respectively). There was no significant difference in evidence-based knowledge among healthcare professionals from metropolitan, regional and rural backgrounds. However, healthcare professionals who used clinical guidelines scored significantly higher than those who did not (P < 0.0001). Greater utilisation of clinical guidelines could improve the evidence-based knowledge of maternity carers. However, the absence of antenatal asthma management in obstetric- and maternity-specific guidelines poses a potential barrier that needs to be addressed. Furthermore, the development of multidisciplinary antenatal clinics, staffed by respiratory nurses and/or physicians, could improve outcomes for pregnant women with asthma who are not undertaking shared care.

Perceptions of Nut Consumption amongst Australian Nutrition and Health Professionals: An Online Survey.

Habitual nut consumption is associated with reduced risk of chronic diseases; however, consumption levels in Australia are below recommendations. This study examined perceptions and knowledge regarding nut consumption among Australian healthcare professionals and their provision of nut consumption recommendations. A cross-sectional online survey of Australian health professionals was conducted in February–April 2020. Questions in the survey included demographic details, participants’ perceptions of nut consumption, and nut consumption recommendations they may make to clients and patients. A total of 204 health professionals completed the survey, of which 84% were dietitians or nutritionists. Health professionals demonstrated basic nutritional knowledge regarding nut consumption; however, non-dietitians/nutritionists lacked knowledge of long-term benefits of nut consumption. Dietitians/nutritionists were more likely to agree that nuts are healthy and do not cause weight gain when compared to non-dietitians/nutritionists (p = 0.021). A total of 63% of health professionals advised at least some of their clients to eat more nuts, and this was higher among dietitians/nutritionists (68%) than non-dietitians/nutritionists (31%). While basic nutritional knowledge regarding nut consumption was observed among all health professionals, there is scope for further education, particularly for non-dietitians/nutritionists, to ensure that nutrition information provided to patients and clients is accurate and reflects the current evidence base.

Willingness to Work amongst Australian Frontline Healthcare Workers during Australia's First Wave of Covid-19 Community Transmission: Results of an Online Survey.

The majority of research investigating healthcare workers' (HCWs) willingness to work during public health emergencies, asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to the actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia's first wave of the COVID-19 pandemic among frontline HCWs. Participants (n = 580) completed an online questionnaire regarding their willingness to work during the pandemic. A total of 42% of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. A third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable while a quarter of participants had received communications from their workplace concerning obligations to work during COVID-19. The COVID-19 pandemic has impacted Australian frontline HCWs' willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW's. This research provides insight into the lived experiences of Australian healthcare professionals' willingness to work during a pandemic.

Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review

BackgroundThere is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms. AimEvaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations. MethodsThe search included EMBASE, PubMed, the National Health and Medical Research Council’s Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/not-for-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines were appraised by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. FindingsA total of 48 guidelines were found, of which 41% provided recommendations that were not limited to routine vitamin and mineral supplementation. There were wide variations in recommendations, particularly for vitamin D and calcium. There was some consensus on recommending ginger and vitamin B6 for nausea and vomiting, and additional supplementation for women with obesity. Guidelines generally scored poorly in the domains of editorial independence and rigour of development. DiscussionThere is a lack of guidance with regard to appropriate CMT use during pregnancy, which may result in less-than-optimal care. Inconsistency between guidelines may lead to variations in care. ConclusionGuidelines should include clear and unambiguous guidance on appropriate CMT use during pregnancy, be based on a structured search of the evidence and informed by stakeholder engagement.