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.
ABSENCE OF ‘OVER-THE-COUNTER’ MEDICINAL PRODUCTS IN ON-LINE PRESCRIPTION RECORDS: A RISK FACTOR OF OVERLOOKING INTERACTIONS IN THE ELDERLY.
By: Olesen C, Harbig P, Barat I, et al
Pharmacoepidemiology and Drug Safety 2013 (Feb) 22(2): 145-150.
Summary: This study was designed to assess possible origins of harmful interactions in elderly patients arising from the current absence of information on over-the-counter (OTC) medicines in the Danish ‘on-line prescription record’ by home visit interviews. Of the 309 patients (median age 75years), 229 (74%) used 568 OTC medicines not listed in the Danish ‘on-line prescription record’, amongst which were identified 166 potential interactions – between OTC treatments or between OTC and prescription drugs. The absence of information on OTC products in an on-line prescription record entails a risk of overlooking interactions in elderly patients. Such products should be included in on-line medication records to prevent adverse effects from interactions.
A QUESTIONNAIRE TO DOCUMENT SELF-MEDICATION HISTORY IN ADULT PATIENTS VISITING EMERGENCY DEPARTMENTS.
By: Roulet L, Asseray N, Foucher N, et al
Pharmacoepidemiology and Drug Safety 2013 (Feb) 22(2): 151-159.
Summary: The aim of this study was to develop the first questionnaire to obtain a complete medication history by documenting self-medication history in adult patients admitted to a medical emergency department (ED). A Questionnaire was piloted and refined in a tertiary care medical ED in 2008. This questionnaire complements the traditional tools that are already available to collect medication histories of prescribed drugs. It may improve the recognition of iatrogenic conditions related to self-medication, and provide support to public health efforts and research programs on self-medication.
FACTORS INFLUENCING CONSUMER PURCHASING PATTERNS OF GENERIC VERSUS BRAND NAME OVER-THE-COUNTER DRUGS.
By: Kohli E, Buller A.
Southern Medical Journal 2013 (Feb) 106(2): 155-160.
Summary: US consumers spend more than $20 billion/year on over-the-counter (OTC) drugs. Brand name formulations continue to lead the OTC drug market with a higher market share than generics. This study was to establish what factors influence US consumers to purchase generic versus brand name OTC drugs with survey data. Results revealed that the single most influential factor for participants when purchasing OTC drugs was lower cost. Although economic factors play an important role in influencing consumers to choose generic formulations, a variety of other factors including advertisements, duration of the OTC effectiveness, severity of sickness, preferable form of OTC medication, safety of the OTC, relief of multiple symptoms, and preferred company will persuade others to pay more for brand name drugs.
FIVE YEARS OF NON-PRESCRIPTION OSELTAMIVIR: EFFECTS ON RESISTANCE, IMMUNIZATION AND STOCKPILING.
By: Gauld NJ, Jennings LC, Frampton C et al
J Antimicrob Chemother 2012 Online first Sept 4, 2012.
Summary: In 2007 New Zealand (NZ) became the first country to make oseltamivir (Tamiflu) available offprescription. This study investigated the extent of pharmacist supply of oseltamivir over 5 years, including during the influenza A(H1N1) pandemic, and the impact of pharmacist supply of oseltamivir on influenza virus, oseltamivir susceptibility, personal stockpiling and influenza vaccine uptake. Five years of non-prescription oseltamivir in NZ has resulted in no significant change in the development of resistance or rates of influenza immunization. Supplies remained modest and significant consumer stockpiling through pharmacist supply has not occurred, even during the influenza A(H1N1)pdm09 pandemic in 2009 and 2010. Pharmacists could be better utilized in ensuring fast distribution of antivirals to influenza sufferers during a pandemic.
OVER-THE-COUNTER PRESCRIBING AND PHARMACISTS’ ADOPTION OF NEW MEDICINES: DIFFUSION OF INNOVATIONS.
By: Paudyal V, Hansford, D., Scott Cunningham S, et al
Research in Social and Administrative Pharmacy 2012 july Epub.
Summary: More than 90 medicines in the United Kingdom alone have been reclassified from “prescription only” to “pharmacy” availability, and many of these have further been deregulated to “general sales” status. Pharmacist perspectives of reclassified medicines adoption into practice are important to inform future reclassifications. This study was to explore the factors associated with adoption into practice of newly reclassified medicines by community pharmacists based on the theoretical framework of diffusion of innovations. Pharmacists’ decision making regarding adoption of newly reclassified medicines is a complex and multidimensional process. This is the first study of this sort, and results of this qualitative study will aid development of a research instrument aimed at quantifying the importance of the factors identified.
USING THE THEORY OF PLANNED BEHAVIOR TO PREDICT SELF-MEDICATION WITH OVER-THE-COUNTER ANALGESICS.
By: Pineles LL, Parente R
J Health Psychol December 6, 2012 Published online before print December 6.
Summary: Millions of people worldwide use over-the-counter analgesics on a regular basis; yet little is known about how decisions to self-medicate are made. This study used the theory of planned behavior to explore the influence of beliefs about medicines (Beliefs about Medicines Questionnaire) and individual pain experience as predictors of intent to self-medicate. Both emerged as significant predictors of intent to self-medicate. Furthermore, intent to self-medicate significantly predicted reported use of analgesics. These findings indicate that use of over-the-counter pain medication is more likely when the value of the pain relief is greater than concerns about harm.
OPPORTUNITIES AND CHALLENGES: OVER-THE-COUNTER CODEINE SUPPLY FROM THE CODEINE CONSUMER’S PERSPECTIVE.
By: Nielsen S, Cameron J, Pahoki S.
International Journal of Pharmacy Practice Article first published online: 25 Oct 2012.
Summary: This study aimed to gain a better understanding on perspectives of over-the-counter (OTC) codeine users and issues relating to codeine dependence in the community pharmacy setting. Examining OTC codeine users’ experiences aimed to promote better understanding of OTC codeine dependence, and inform pharmacy practices. The experiences of participants suggest a number of barriers exist to effective intervention for OTC codeine dependence in the community pharmacy setting. Identification of these barriers will provide an opportunity to more effectively target interventions to reduce harm related to OTC codeine products. Increased involvement of pharmacists in OTC codeine sales was associated with help-seeking by codeine users.
HOW PATIENTS VIEW PROBIOTICS: FINDINGS FROM A MULTICENTER STUDY OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND IRRITABLE BOWEL SYNDROME
By: Mercer M, Brinich MA, Geller G, et al.
Journal of Clinical Gastroenterology: February 2012 – Volume 46 – Issue 2 – p 138–144.
Summary: Patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have access to a growing number of probiotic products marketed to improve digestive health. It is unclear how patients make decisions about probiotics and what role they expect their gastroenterologists to play as they consider using probiotics. Understanding patients’ knowledge, attitudes and expectations of probiotics may help gastroenterologists engage patients in collaborative discussions about probiotics. Study findings suggest that patients with IBD and IBS will look to gastroenterologists and other clinicians as trustworthy advisors regarding the utility of probiotics as an alternative or supplement to pharmaceutical drugs. Gastroenterologists and other clinicians who care for patients with these diseases should be prepared to discuss the potential benefits and risks of probiotics and assist patients in making informed decisions about their use.
OVER-THE-COUNTER ACCESS TO EMERGENCY CONTRACEPTION WITHOUT AGE RESTRICTION: AN OPINION OF THE WOMEN’S HEALTH PRACTICE AND RESEARCH NETWORK OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.
By: Rafie S, McIntosh J, Gardner DK, et al.
Pharmacotherapy 28 Feb 2013; online first.
Summary: Family planning remains a high priority area for the United States, with goals to increase the proportion of pregnancies that are intended, reduce pregnancy rates among adolescents, and increase contraceptive use prioritized in the Healthy People 2020 objectives. Contraception intended for use after unprotected intercourse, known as emergency contraception, remains under-utilized. Levonorgestrel is one method of oral emergency contraception, which prevents fertilization and does not disrupt an already established pregnancy; thus, timing of administration is critical. Despite data demonstrating safety and efficacy, evidence-based decision making has been overshadowed by politically charged actions involving levonorgestrel emergency contraception for over a decade. The Women’s Health Practice and Research Network of the American College of Clinical Pharmacy supports expanded access to levonorgestrel emergency contraception and removal of barriers such as age restrictions on the nonprescription drug product. Pharmacists remain a key provider of emergency contraceptive services and can help ensure timely access. In states where direct pharmacy access to emergency contraception is available, pharmacists are encouraged to participate. Education, research, and advocacy are other important responsibilities for pharmacists in this arena.
RESULTS OF A NATIONAL SURVEY ON OTC MEDICINES, PART 3: PERCEIVED TIME EXPECTATIONS FOR CLINICAL ENCOUNTERS ASSOCIATED WITH OVER-THE-COUNTER MEDICINES.
By: Tsuyuki RT, Landry E, Lalonde L, Taylor J.
Canadian Pharmacists Journal May 2012; 145 (3):116-118.
Summary: A cross-sectional survey of practising community pharmacists across Canada to investigate their perceptions of patient expectations for consultation time on OTC use. A total of 2305 usable surveys were received of 5037 originally mailed out (46% response rate). Pharmacists’ perceptions of time for OTC product consultation were generally quite short, from a low of 1.7 minutes (mean) for paracetamol/caffeine/codeine 8mg and ASA 81mg, to a high of 3.6 minutes (mean) for permethrin crème rinse (Nix). In general, pharmacists felt that patients’ expectations for clinical interaction associated with first-time OTC use would be about 2 minutes. This can serve as the basis for development of pharmacist interventions to improve OTC use, balancing patient expectations for the duration of the interaction with what would be clinically important to cover during that interaction. This includes managing patients’ expectations for appropriate pharmacist interactions.
BALANCING THE RISKS AND BENEFITS OF THE USE OF OVER-THE-COUNTER PAIN MEDICATIONS IN CHILDREN.
By: Bárzaga Arencibia Z, Choonara I.
Drug Safety December 2012, Volume 35, (12), 1119-1125.
Summary: Paracetamol (acetaminophen) and ibuprofen are the most frequently purchased over-the-counter (OTC) medicines for children. Parents purchase these medicines for the treatment of fever and pain. In some countries other NSAIDs such as aspirin (acetylsalicylic acid) and dipyrone are available. We aimed to perform a narrative review of the efficacy and toxicity of OTC analgesic medicines for children in order to give guidance to health professionals and parents regarding the treatment of pain in a child. Neither aspirin nor dipyrone are recommended for OTC use because of the association with Reye’s syndrome for the former and the risk of agranulocytosis for the latter. Both paracetamol and ibuprofen are effective for the treatment of mild pain in children. Adverse effects with both medicines are infrequent. Ibuprofen is an NSAID and therefore there is a greater risk of gastrointestinal adverse effects and hypersensitivity. Aspirin and dipyrone should be avoided. Paracetamol is the drug of first choice for mild pain in children because of its favourable safety profile. For the treatment of significant musculoskeletal pain, ibuprofen is the drug of first choice.