SelfCare Focus 8.2

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.

Health self-care in the United States.

By: Shandra CL, Sonalkar N.

Public Health 2016; 138: 26-32.

Summary: This report purports to provide the most recent population-level estimates of time spent in health self-care (taking medicine, giving an injection, wound care, etc). They looked at cross-sectional data on adults (n = 36,033) from the nationally representative 2008, 2010, and 2012-2013 American Time Use Survey. Results: Overall, 6.7% of the population reported health self-care on an average day, among whom an average of 76.6 min is spent in care. Individuals are most likely to report self-care in the morning, perform 76.1% of their care alone, and 97% in their own homes. These trends varied across sex, race/ethnicity, age, income, education, employment, disability, and health.



Self-care of long-term conditions: patients’ perspectives and their (limited) use of community pharmacies.

By: Ogunbayo OJ, Schafheutle EI, Cutts C, Noyce PR.

International Journal of Clinical Pharmacy 2017; 39: 433-42.

Summary: Self-care is an inseparable component of quality healthcare for long-term conditions (LTCs). Evidence of how patients view and use community pharmacies (CP) to engage in self-care of LTCs is limited. The report explored patient perspectives of engaging in self-care and use of CP for self-care support. Twenty-four participants were interviewed. One theme that evolved was that self-care was very personal and diverse and was based on beliefs and experiences. Healthcare professionals were viewed as providing information which was considered passive and insufficient in helping behavioural change. Non-healthcare sources (family, friends, internet) were important in filling active support gaps, particularly lifestyle management.



Prevalence of homeopathy use by the general population worldwide: A systematic review.

By: Relton C, Cooper K, Viksveen P, Fibert P, Thomas K.

Homeopathy. 2017 May;106(2):69-78.

Summary: The authors systematically reviewed surveys of 12-month prevalence of homeopathy use by the general population worldwide. Twelve-month prevalence of treatment by a homeopath was reported in 24 surveys of adults. Rates in the USA, UK, Australia and Canada all ranged from 0.2% to 2.9% and remained stable over the years surveyed (1986-2012). The highest use was reported by a survey in Switzerland where homeopathy is covered by mandatory health insurance.



Consumer views on safety of over-the-counter drugs, preferred retailers and information sources in Sweden: After re-regulation of the pharmacy market.

By: Westerlund T, Barzi S, Bernsten C.

Pharm Pract (Granada). 2017 Jan-Mar;15(1):894.

Summary: The aim was to examine the general public’s views on safety, purchasing and information channels, storage and disposal of OTCs in Sweden, three years after the re-regulation of the pharmacy market. A total of 8302 people answered the questionnaire. Seven percent found OTCs completely harmless regardless of how they are being used, 18% felt they should be used only on health professionals’ recommendation. Differences in how OTCs are perceived were however found with regards to respondents’ country of birth, family type, educational level and income. The pharmacy was still the preferred OTC drug retailer by 83% of the respondents and preferred information source by 80% Reasons for preferred retailers were primarily due to out of habit (45%), counseling provided (35%), the product range (34%) and the confidence in staff (27%).



Self-medication among people living with hypertension: A review.

By: Rahmawati R,  Bajorek BV.

Fam Pract. 2017 Apr 1;34(2):147-153.

Summary: This review explored the scope of self-medication practices among people with hypertension. On average, 25% of patients used CAMs (mostly herbs) to lower blood pressure. Recommendations by family, friends and neighbours were the most influential factors. Faith in treatment with CAMs, dissatisfaction with conventional medicine and the desire to reduce medication costs were also cited. Most (70%) patients with hypertension take OTC medicines to treat minor illnesses, commonly seen as analgesics and herbal medicines.



Systematic education of self-medication at Tokyo university of pharmacy and life sciences.

By: Narui K, Samizo K, Inoue M, Watanabe K.

Yakugaku Zasshi. 2016;136(7):945-50.

Summary: The promotion of self-medication by pharmacies, with the aim of encouraging self-selection of appropriate OTC drug, is written about in the national action plan “Japan is Back”. The subject of self-medication has been improved in the 2013 “Model Core Curriculum for Pharmaceutical Education”. At Tokyo University of Pharmacy and Life Sciences, the systematic education of self-medication was started from the onset of the six-year course in the third, fourth and fifth grade. They introduce here a new approach in their systematic education of self-medication. Students ask about patient symptoms, choose an OTC drug suitable, and explain the OTC drug to patient actors. After the role-playing, those in the roles of observers give feedback to the student who played the role of pharmacist.



Over-the-counter medications containing diphenhydramine and doxylamine used by older adults to improve sleep.

By: Abraham O, Schleiden L, Albert SM.

International Journal of Clinical Pharmacy 2017; May: 1-10.

Summary: The 2015 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults recommends that individuals 65 years or older avoid use of diphenhydramine and doxylamine, yet many OTC sleep products contain these active ingredients. This work identified the proportion of older adults using an OTC medication containing diphenhydramine or doxylamine. The study sample was taken from a larger survey of 1025 participants on sleep health and OTC sleep medication use conducted from February to April 2015. A subset of 169 participants aged 65 and older reporting taking at least one OTC product to improve sleep within the past 30 days (16.5%). Of the 223 OTC sleep medications listed by participants, 115 (52%) contained diphenhydramine or doxylamine.



Dangers of nonprescription medicines: Educating and counseling older adults.

By: Kinsey JD, Nykamp D.

Consult Pharm. 2017 May 1;32(5):269-280.

Summary: This was a review for health care providers regarding appropriate education and counseling for older adults involving commonly used OTC medicines. A literature search was performed using MEDLINE and PUBMED to locate relevant work between March 2008 and December 2016. They concluded that OTC medicines are accessible and widely used by older adults. Polypharmacy and drug duplication are concerns because of negative outcomes. Given the accessibility and knowledge of pharmacists, they are often asked questions regarding nonprescription medicines. Pharmacists have a duty and responsibility to commit to lifelong learning and to provide appropriate education and counseling on their use.



Overuse and Misperceptions of Nonsteroidal Anti-inflammatory Drugs in the United States.

By: Cryer B, Barnett MA, Wagner J, Wilcox CM.

Am J Med Sci. 2016 Nov;352(5):472-480.

Summary: The availability of hundreds of products containing an NSAID, combined with a lack of recognition and understanding of NSAIDs, can increase the potential of consumers to inadvertently exceed the recommended dosage, which can cause potentially serious side effects. An online and telephone survey of 1750 US adults was conducted to obtain information about the patterns of use and perceptions about prescription and over-the-counter NSAIDs and medicines. The survey was compared to similar surveys conducted in 1997, 2001 and 2002. NSAIDs were widely used, with 63% of respondents reporting use within the past 12 months. NSAIDs were not well recognized by generic or brand names and many respondents were unaware or unconcerned about potential side effects. NSAID misuse was common, with 19% using more than the recommended dose and 24% using multiple NSAIDs concomitantly. NSAID use appears to have increased since 2002 but the level of NSAID awareness and pattern of NSAID misuse has not changed.



Findings from an Online Survey Assessing the Burden and Management of Seasonal Allergic Rhinoconjunctivitis in US Patients.

By: Meltzer EO, Farrar JR, Sennett C.

Journal of Allergy and Clinical Immunology: In Practice 2017; 5: 779-789.

Summary: Seasonal allergic rhinoconjunctivitis (SARC) affects about 16% of the US population annually. The objective of this study was to assess the patient-perceived burden of SARC in relation to newer treatments, increased access to treatments, and changing management protocols. An online survey of symptom experience was conducted in US respondents who suffer (or whose child suffers) from SARC symptoms. A total of 1001 surveys were completed. Before being treated, >50% of respondents reported daily symptoms during their season; 75% to 80% considered their symptoms moderate to severe. Patients saw a variety of health care professionals (including pharmacists) and used OTC and prescription medications for symptoms. Those using prescription medications were generally more satisfied with treatment and less likely to switch or discontinue treatment.