Using natural language processing to characterize and predict homeopathic product-associated adverse events in consumer reviews: comparison to reports to FDA Adverse Event Reporting System (FAERS).

OBJECTIVE: Apply natural language processing (NLP) to Amazon consumer reviews to identify adverse events (AEs) associated with unapproved over the counter (OTC) homeopathic drugs and compare findings with reports to the US Food and Drug Administration Adverse Event Reporting System (FAERS). MATERIALS AND METHODS: Data were extracted from publicly available Amazon reviews and analyzed using JMP 16 Pro Text Explorer. Topic modeling identified themes. Sentiment analysis (SA) explored consumer perceptions. A machine learning model optimized prediction of AEs in reviews. Reports for the same time interval and product class were obtained from the FAERS public dashboard and analyzed. RESULTS: Homeopathic cough/cold products were the largest category common to both data sources (Amazon = 616, FAERS = 445) and were analyzed further. Oral symptoms and unpleasant taste were described in both datasets. Amazon reviews describing an AE had lower Amazon ratings (X2 = 224.28, P < .0001). The optimal model for predicting AEs was Neural Boosted 5-fold combining topic modeling and Amazon ratings as predictors (mean AUC = 0.927). DISCUSSION: Topic modeling and SA of Amazon reviews provided information about consumers' perceptions and opinions of homeopathic OTC cough and cold products. Amazon ratings appear to be a good indicator of the presence or absence of AEs, and identified events were similar to FAERS. CONCLUSION: Amazon reviews may complement traditional data sources to identify AEs associated with unapproved OTC homeopathic products. This study is the first to use NLP in this context and lays the groundwork for future larger scale efforts.

Investigation and analysis of the current usage status of OTC drug among Inner Mongolian residents / 中国药房

OBJECTIVE To investigate the current usage status of OTC drug among residents in Inner Mongolia Autonomous Region， and to provide evidence for the science popularization of rational drug use. METHODS By approximate random sampling， the questionnaire survey was conducted with the mini-apps Questionnaire Star among the residents aged 19 and above from 7 league or cities of Inner Mongolia Autonomous Region， in order to investigate the current situation of OTC drug use in the region. RESULTS A total of 611 people filled in the questionnaire， and 571 people filled in the questionnaire effectively， with an effective filling rate of 93.45%. According to the results， 18.7% of residents said they did not understand the concept of OTC drugs， 36.1% of residents said they did not know the OTC drug label， and 65.3% of residents did not know the difference between class A and B OTC drugs in terms of OTC drug awareness. And there were statistically significant differences in the scores of OTC drug awareness among different genders， education levels， monthly income and places of residence （P＜0.05）. When choosing OTC drugs， 23.5% of residents still believed in advertisements or friends’ recommendations； 14.5% of the residents did not read the drug instructions carefully before taking drugs. In terms of drug risk， 5.1% of residents had long-term use of OTC drugs； 8.6% of residents reported taking three or more OTC drugs； 2.1% of residents often added other drugs with the same effect or increased the dosage by themselves. They took traditional Chinese medicine， Mongolian medicine and other preparations while taking OTC drugs， accounting for 19.6%， 22.6% and 13.0% respectively. CONCLUSIONS Residents in Inner Mongolia have low awareness of OTC drugs， and their habits of drug use need to be improved. Repeated drug use and overdose drug use are serious， it is necessary to strengthen the publicity and popularization of rational use of OTC drugs.

Factors That Influence the Use of Dietary Supplements among the Students of Wroclaw Medical University in Poland during the COVID-19 Pandemic.

BACKGROUND AND AIM: The use of dietary supplements (DS) and over-the-counter (OTC) drugs is increasing every year. The COVID-19 pandemic might additionally influence the use of such preparations. The study aimed to investigate factors influencing the use of dietary supplements (DS), including stress-relieving supplements, by the students. METHODS: In the cross-sectional study, 624 students of the Wroclaw Medical University in Poland, from the second to the last year of studies, completed the anonymous questionnaire, consisting of 22 items, about the use of DS/OTC drugs during the academic year 2020/2021. Obtained data were analyzed using Pearson's chi-square test, the U-Mann Whitney test, the Kruskal-Wallis test with the post-hoc analysis, and with logistic regression. RESULTS: About 70% of students declared the use of any DS, 33% used DS for stress, anxiety, depression, or sleeping problems, and 59% used other DS. The most important factors influencing the decision to take any kind of DS were Division (p = 0.0001, odds ratio [OR]: 0.35, and confidence interval [CI]: 0.21-0.59), a self-estimated level of stress (p = 0.014, OR: 1.13, CI: 1.03-1.25), and self-estimated level of knowledge about DS (p = 0.0000, OR: 1.31, CI: 1.19-1.36). In the case of students taking DS for stress, anxiety, depression, or sleeping problems, the level of stress and the declared knowledge had the greatest impact on the decision for such a use of DS (p = 0.0001, OD: 1.24, CI: 1.11-1.39 and p = 0.0000, OD: 1.35, CI: 1.22-1.5, respectively). The COVID-19 pandemic did not change the pattern of DS/OTC drug usage in about 33% of students. Those who started taking DS during the pandemic accounted for 19% of all students. CONCLUSIONS: The use of DS is common among Wroclaw Medical University students with some differences between subgroups of respondents. Additionally, despite declared good knowledge about DS, most students declare the need to learn more about them.

Investigation Study on Family Self-medication Behavior of Residents in Gansu Province Based on PRECEDE- PROCEED Model / 中国药房

OBJECTIVE：To promote rational use of OTC in the family ，and to provide reference for the formulation of related policy by health administration department. METHODS ：By stratified cluster sampling method ，using residents of 4 cities from Gansu province as objects ，face-to-face questionnaire household survey was conducted in Jan. 2019. The general information of the residents and their family self-medication behaviors were collected ，and the influential factors [tendency factors （including cognition of OTC and attitude towards self-medication ），contributing factors and strengthening factors ，and odds ratio （OR）was used to study the correlation between factors and results] of self-medication behaviors were analyzed by PRECEDE-PROCEED model. Epi Data 3.10 software was used to establish database ，and SPSS 16.0 software was adopted to analyze the family self-medication behavior of residents statistically. RESULTS ：A total of 3 600 questionnaires were sent out ，and 3 111 valid questionnaires were recovered ，with an effective recovery rate of 86.4％. 81.8％（2 541/3 106）of the respondents had self- medication behavior in the past 1 year. The results of binary Logistic regression and χ2 test showed that female residents ，irregular daily life ， no chronic disease ，low monthly family income ，new rural cooperative medical care and urban residents ’medical insurance were more inclined to self-medication. In the tendency factors ，residents who knew that OTC could be purchased in the pharmacy without the doctor ’s prescription （OR＝1.322）， Δ 基金项目 ：国家自然科学基金资助项目 （No.41405108， No.21472077） drug package with OTC logo （OR＝1.397）and the Chinese ＊讲师，硕士。研究方向：药物新制剂、新剂型、新技术。E-mail： herbal medicine also had toxic side effects （OR＝1.750），the 410843130@qq.com possibility of self-medication was greater ；the residents who # 通信作者：教授，博士。研究方向：药物活性分子的设计与合 seldom cleaned the family medicine box （OR＝0.462），quick 成。E-mail：wangshh@lzu.edu.cn and effective drugs （OR＝0.670） and ADR （OR＝0.688） 中国药房 2020年第31卷第11期 China Pharmacy 2020Vol. 31 No. 11 ·1377· were the factors that prevent the occurrence of se lf-medication behavior ，while low drug price （OR＝5.298）was the tendency factor of self-medication behavior. In the contributing factors ，the incidence of self-medication of residents with regular drugs in their home was 2.997 times higher than that those without reserves ；the convenience of self-medication （OR＝1.376），the proximity of drugstores to home （OR＝1.680），the credibility of drug quality （OR＝1.355） had a facilitating effect on the occurrence of self-medication. In the strengthening factors ，the suggestions of relatives and friends （OR＝3.388），books， newspapers and TV network advertisements （OR＝2.043）had a strengthening effect on the occurrence of self-medication. The above factors had a significant effect on the residents ’self-medication（P＜0.05）. CONCLUSIONS ：The family self-medication behavior of residents in Gansu province is common. The residents with higher cognitive level tend to self-medication ；the lower the drug price ，the more likely the self-medication behavior will occur. The factors contributing to the occurrence of self-medication are the regular drugs at home ，the proximity of drugstores to home ，and the credibility of drug quality. The suggestions of relatives and friends，online advertising and other factors are the strengthening factors of the occurrence of self-medication behavior.

The Impact of the Socio-Demographic Characteristics of Complementary and Alternative Medicine Users in Serbia on OTC Drug Consumption.

The Aim of this research is to analyze how the socio-demographic characteristics of users of Complementary and Alternative Medicine (CAM) in Serbia influence and impact their consumption of OTC drugs. Respondents and methods: The study employed the third edition of the National Health Survey of the Republic of Serbia, published in 2013, as a data source covering the Serbian population. The sample comprised of 550 interviewed individuals who had been applying a variety of CAM treatments over the previous 12 months. Their socio-demographic characteristics were used as independent variables impacting the consumption of OTC drugs over the previous 2-week period, representing the dependent variable. Results: Two thirds (65.3%) of the CAM users consumed OTC drugs at their own discretion, without recommendation by a physician or a relevant prescription. Users of OTC drugs were most often females whose ages ranged within the average interval of 49.16 ± 16.02, whose education level was to secondary school diploma, who were married and employed, lived in urban areas, mostly Belgrade, belonged to the middle-income group, and followed relevant headlines via public information channels (TV, the internet, radio, and print). Comparison of the results revealed, on the one hand, that 2/3 of respondents who had used and 1/3 of those who did not consume OTC drugs had undergone fecal occult blood tests over the past year (p < 0.05) and, on the other hand, that those respondents had been less frequently hospitalized in the previous year (p = 0.05). In addition, the same responders were found to access available health care services more frequently than did others (p < 0.05). Conclusion: Since, according to the statistics, it is highly likely that respondents who were CAM- and OTC drug-users would be less frequently hospitalized and not use medical leave, these results provide a strong indication that this phenomenon should be investigated in more depth. Moreover, the areas to be considered when defining strategies for determining patient treatments should also include the influence of socio-demographic factors on the patient's consciousness that would enable easier understanding of the proper usage of OTC drugs.

The utilization of nonprescription medications in Saudi patients with cardiovascular diseases.

BACKGROUND: Cardiovascular diseases (CVDs) are the most common cause of disease-related death in Saudi Arabia. The incidence of CVDs continues to increase, presenting a major health care problem. Nonprescription medications are widely used by patients with CVD and may cause adverse drug events, either by worsening the disease or by harmfully interacting with prescribed medications. We investigated the patterns of nonprescription medication utilization and the factors associated with their use in patients with CVD. METHODS: This was a cross-sectional study conducted at the Cardiology Clinics of an academic tertiary health care center. Participants were asked about their sociodemographic characteristics, medical history and frequency of using nonprescription medications including over-the-counter (OTC) products, dietary supplements, and herbal products. Moreover, we investigated the participants' sources of information about nonprescription medications. Multivariate logistic regression analysis was conducted to examine the predictors of nonprescription medication use. RESULTS: A total of 209 participants were interviewed. The mean age of the participants was 56 ± 15 years, and 110 (52.6%) were female. Of the 209 participants, 116 (55%) reported routine use of nonprescription medications. Black seeds and garlic were the most frequently used herbal products. Acetaminophen, cold/cough remedies, and ibuprofen were the most commonly reported OTC drugs. Of the surveyed patients, 54 (46.5%) used nonprescription medications to manage cardiovascular conditions specifically. Compared with other comorbidities, diabetes mellitus was associated with a higher use of nonprescription medications. CONCLUSION: In patients with CVD, the routine use of nonprescription medications was common for a number of reasons. Health care providers should proactively discuss nonprescription use with their CVD patients to avoid potential harmful outcomes.

The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?

Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor. Whether these pathways to recreational and medical cannabis are separate or somewhat tangled remains largely unknown. There have been few studies examining cannabis use among the growing population of Americans aged 65 and older. In this essay, we illuminate what is known about the intersection between cannabis and the aging American population. We review trends concerning cannabis use and apply the age-period-cohort paradigm to explicate varied pathways and outcomes. Then, after considering the public health problems posed by those who misuse or abuse cannabis, we turn our attention to how cannabis may be a viable policy alternative in terms of supporting the health and well-being of a substantial number of aging Americans. On the one hand, cannabis may be an effective substitute for prescription opioids and other misused medications; on the other hand, cannabis has emerged as an alternative for the undertreatment of pain at the end of life. As intriguing as these alternatives may be, policy makers must first address the need for empirically driven, representative research to advance the discourse.