SelfCare Focus 8.3

A selection of newly published papers on self-care from the worldwide literature

Every week, we will provide a brief summary and a link to the published abstract of newly published papers selected from the worldwide literature as being of particular interest to the SelfCare community.

Management of respiratory tract infections in young children – A qualitative study of primary care providers’ perspectives.

By: Biezen R, Brijnath B, Grando D, Mazza D.

Primary Care Respiratory Medicine 2017; 27 (1): Article Number: 41533.

Summary: Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective.
The findings indicate that factors such as primary care provider time constraints, parental anxiety, general practitioner perception of what parents want, perceived parental pressure, and fear of losing patients were some of the reasons why primary care providers did not always adhere to guideline recommendations. Primary care providers also provided conflicting advice to parents concerning OTC medications and when children should resume normal activities.



International variability in the prevalence of insomnia and use of sleep-promoting medications, supplements, and other substances.

By: Havens CM, Grandner MA, Youngstedt SD, Pandey A, Parthasarathy S.

31st Anniversary Meeting of the Associated Professional Sleep Societies — SLEEP 2017. United States. pp A117-A118.

Summary: Few studies have compared insomnia prevalence across multiple countries using standardized measures. An international web-based survey was conducted across 10 countries with 7817 respondents. The prevalence of insomnia ranged from 5.4% (Netherlands) to 30.5% (Brazil). Use of over-the-counter medications and supplements was consistently more common in the US.


Misuse of over the counter medicines in community pharmacies in Scotland.

By: Hill D, McCabe A, Paterson K, Stuart J, Campbell D.

Journal of Substance Use 2017; May: pp 1-7.

Summary: This article examined the self-reported use of medication from a small sample of community pharmacies in Scotland. Data were collected over a short time period in 2015 from 15 community pharmacies. The data demonstrate the widespread misuse of OTC. The most prevalent group identified as females, between 41 and 60 years of age. It was most commonly reported that the recommended treatment duration is exceeded rather than the maximum recommended daily dose.



Decision-making in men considering use of non-prescription tamsulosin for lower urinary tract symptoms.

By: Cohn J, Dmochowski R, Kowalik C, Roehrborn C, Bierer D, Verbeek A, Wruck J.

112th Annual Meeting of the American Urological Association, 2017. J Urol 2017; 197 (4 Supplement 1): e104.

Summary: The researchers aim was to assess appropriate decision-making in men choosing to use tamsulosin in a simulated OTC setting for lower urinary tract symptoms. Adult men not taking a prescription medication for benign prostatic hyperplasia (BPH) were shown a mock-up of the drug packaging and asked if the medication would be appropriate for their personal use. Three urologists reviewed the data of men reporting the product to be appropriate for their use who did not meet appropriate self-selection criteria. 470/619 (75.9%) eligible men self-selected use. The proportion of men meeting appropriate self-selection criteria on unmitigated and mitigated analyses was 92.8% and 97.9%.


Management of allergic rhinitis in the era of effective over-the-counter treatments.

By: Carr WW and Yawn BP.

Postgraduate Medicine 2017; Jun 9: pp 1-9.

Summary: Up to two thirds of patients self-manage AR before seeking medical care. For many patients, the impact on quality of life is greater than suggested by reported symptoms and should also be a focus of treatment. The authors feel that while many patients can effectively manage AR symptoms independently, a significant percentage will need direction from a physician to obtain optimal results. The availability of several different classes of treatment (decongestants, antihistamines, intranasal corticosteroids (INS)) has increased the complexity of self-management, leaving patients confused about the best approach to treatment. Treatment guidelines universally classify INS as the most effective medical agents available for use in the OTC and primary care settings. But, patients may have negative perceptions about their safety and may have experienced unpleasant taste, scent, and feel with nasal sprays. This article reviews the primary care management of AR in the context of the availability of effective OTC medicines.



Implications of dispensing self-administered hormonal contraceptives in a 1-year supply: a California case study.

By: McMenamin SB, Charles SA, Tabatabaeepour N, Shigekawa E, Corbett G.

Contraception 2017; 95: 449-451.

Summary: As of September 2016, California became the sixth state to pass legislation requiring health plans and insurers to cover a year supply of self-administered hormonal contraceptives such as contraceptive pills, patches and vaginal rings. This legislation is estimated to result in 38% of current contraceptive pill, patch, and ring users receiving a 12-month supply dispensed at one time. This shift in dispensing patterns was estimated to result in a reduction of 15,000 unintended pregnancies, 2000 fewer miscarriages, and 7000 fewer abortions in California decreasing total net health care expenditures by 0.03%.



A population-based study of risk perceptions of paracetamol use among Swedes-with a special focus on young adults.

By: Håkonsen H, Hedenrud T.

Pharmacoepidemiol Drug Saf. 2017 Jun 5. doi: 10.1002/pds.4238.

Summary: The purpose was to investigate risk perceptions of paracetamol use with a special focus on young adults. A web survey was sent to a representative sample (n = 5838) of the Swedish adult population. Altogether, 3120 persons answered the full questionnaire. Most respondents (70.5%) reported use of paracetamol in the 3 months prior to the study. The highest proportion was found among those aged 18 to 25 years (75.8%). Nine in 10 were OTC paracetamol users. A total of 14.2% thought paracetamol was completely harmless to use, while 54.3% indicated risks associated with use even when following the dosing instructions. One third disagreed that it is less risky to use paracetamol compared with NSAIDs. Three-quarters identified liver damage as a potential consequence of exceeding the recommended maximum daily dose.



Rates of Nonsteroidal Anti-Inflammatory Drug Use in Patients with Established Cardiovascular Disease: A Retrospective, Cross-Sectional Study from NHANES 2009-2010.

By: Castelli G, Petrone A, Xiang J, Shrader C, King D.

American Journal of Cardiovascular Drugs 2017; 17: 243-49.

Summary: The purpose of this study is to evaluate the rates of NSAID use among patients with CVD following the 2005 FDA warning regarding NSAID use and increased CVD risk. This was a retrospective, cross-sectional study of participants from the National Health and Nutrition Examination Survey 2009-2010. Respondents with CVD were 2.1 times more likely to use OTC NSAIDs or prescription NSAIDs than respondents without CVD.



Are antihistamines effective in children? A review of the evidence.

By: De Bruyne , Christiaens T, Boussery K, Mehuys E, Van Winckel M.

Archives of Disease in Childhood 2017; 102:56-60.

Summary: In this paper, the case of first-generation H1-antihistamines is investigated, notably the range of indications for which products are licensed in different European countries and the evidence base (or lack thereof) for each indication, as well as reported adverse drug reactions. The authors concluded that many of the licensed indications of first-generation antihistamines do not appear to be evidence based.