Factors associated with the use of dietary supplements and over-the-counter medications in Japanese elderly patients.

BACKGROUND: The use of dietary supplements and over-the-counter (OTC) drugs is increasing, and there is adequate concern about potential harmful effects. However, there are limited reports on the concurrent use of nonprescription medications with prescription medications in elderly patients. Therefore, this study was conducted to describe the use of dietary supplements and OTC drugs, and to identify predictors for their use in elderly patients using medications prescribed for chronic diseases. METHODS: This was a cross-sectional study that enrolled 729 patients aged ≥65 years with chronic diseases, between January and March 2016. Data regarding socio-demographic status, medical condition, number of prescriptions, use of nonprescription medications, and psychological status were collected using a self-administered questionnaire and by review of medical records. Data regarding use of dietary supplements and OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to investigate factors associated with the use of dietary supplements and OTC drugs. RESULTS: The regular use of nonprescription drugs was reported by 32.5% of patients. Vitamins were the most commonly used dietary supplements in elderly patients. Female sex, higher educational qualifications, and good economic status were identified as predictors for the use of nonprescription medications. Concurrent use of nonprescription medications with more than 5 prescription medications was detected in 12.2% of participants. The disclosure rate of the use of nonprescription medications by patients to the physician was 30.3%. CONCLUSION: The use of dietary supplements and OTC drugs was common in elderly patients with chronic diseases, and its use is associated with sex, education, and economic status. General practitioners (GPs) need to recognize the potential use of nonprescription medications, considering that polypharmacy was common and disclosure rate was low in this study.

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.

Using Instagram Stories to supplement a required self-care pharmacy course.

BACKGROUND AND PURPOSE: Social media is widely used among Americans, with Instagram being especially popular in adults under age 30. There are few examples of the use of Instagram in pharmacy education and no reports of student perspectives on using Instagram to supplement self-care pharmacy coursework. This article describes the design, implementation, and evaluation of a teaching innovation using Instagram Stories to supplement a required self-care course. EDUCATIONAL ACTIVITY AND SETTING: The instructors of Self-Care Therapeutics created an Instagram account to share content as an optional supplement to course topics. The account shares stories featuring real-time questions from friends and family of the instructors, product and device demonstrations, and discussion of current events or news related to over-the-counter products. An anonymous survey was sent to all students at the semester conclusion to gain student perceptions of the posted content. A focus group was conducted to further interpret the survey data. FINDINGS: Of the 89 students enrolled, 51 completed the survey and 30 students followed the course account. Students agreed that the account was helpful for reinforcing information from class and provided information beyond what was discussed in class, but they had mixed perceptions of its utility for exam preparation and application to real life. SUMMARY: Use of Instagram Stories as an alternative method to supplement content in a required self-care course is feasible and received well by students. Use of social media could improve perceived relevance of course topics to students.

Survey of Nonprescription Medication and Antibiotic Use in Patients with Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and Overlap Syndrome.

Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and overlap syndrome (SJS-TEN) are rare, serious skin and mucosa break-down conditions frequently associated with antibiotic use. The role of nonprescription medications alone, or in combination with antibiotics in triggering SJS/TEN, is largely unknown. This study summarized data collected from patient surveys about nonprescription and antibiotic use prior to a SJS/TEN diagnosis. The survey was administered online to members of the U.S. SJS Foundation who had been diagnosed with SJS/TEN or were the parent of a child who had been diagnosed with SJS/TEN. Respondents were asked about nonprescription medications taken within the year before diagnosis, and the approximate point in time before diagnosis that they had taken them. They were also asked about specific prescription medications, including antibiotics, that they took before diagnosis. An estimated 4500 patients received an invitation to complete the survey. 251 patients completed it, resulting in a response rate of 5.6%. The mean age of respondents was 43 years (SD (standard deviation) = 17.3) and 70% were female. 32.3% of respondents indicated that a prescription antibiotic triggered their reaction. 14.1% indicated a nonprescription medication had triggered their SJS/TEN, and 18.1% said a nonprescription medication may have triggered their SJS/TEN. 85.5% of respondents said they took a nonprescription medication within three months of their SJS/TEN diagnosis. Of those respondents who reported that an antibiotic triggered their SJS/TEN, 35.2% reported taking a nonprescription medication within the three months prior to their diagnosis. This survey captured valuable information about nonprescription and antibiotic use in SJS/TEN patients. It is important for future studies to estimate the impact of antibiotics on SJS/TEN, and account for nonprescription medication use in that relationship.

Evolution of self-care education.

During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States.

A small group assignment gives students a novel opportunity to demonstrate current clinical controversies in a self-care course.

OBJECTIVE: To design and implement a small-group assignment on current event, nonprescription drug therapy questions in a self-care course, and to evaluate student performance in predefined areas. DESIGN: Students self-identified a current clinical question in nonprescription therapy, searched primary literature, and presented their findings to peers in class. ASSESSMENT: Students were evaluated using a grading rubric on communication skills, ability to retrieve and analyze biomedical literature, and ability to formulate and defend an evidence-based recommendation. Overall, students performed well in all competencies, with grades ranging from 84% to 100% (median=92%). Faculty members completing a postassignment survey gave positive feedback regarding the educational value of the assignment and the ease of use of the designed rubric. CONCLUSION: A course assignment that involved peer-to-peer presentations and dealt exclusively with applicable, relevant, clinical questions regarding nonprescription drug therapy gave students a novel opportunity to practice drug information skills.

Consumo de medicamentos en profesionales y técnicos/ administrativos de la salud: / Consumo de droga na profissional de saúde, técnicos/ administrativos: / Consumption of medicines in health professionals and technical/ administrative staff:

Resumen: El objetivo del estudio fue establecer la situación de consumo de medicamentos no prescritos en profesionales, técnicos/administrativos de salud y los factores de riesgo asociados. Corresponde a un diseño de corte transversal en 182 profesionales y 578 técnicos/administrativos. Se realizó un análisis descriptivo e inferencial, con nivel de significación 5%. Se cuenta con la aprobación del Comité de Ética y Consentimiento Informado. Se obtuvo como resultado que el 44,9% consume medicamentos no prescritos; al comparar con situación profesional se tiene OR=1,66, IC (1,18-2,32); en consumo de tabaco OR=1,38, IC (1,02-1,87); en consumo de alcohol OR=2,10, IC (1,55-2,86); en hipertensión arterial OR=2,25 IC (1,29-3,91); y cefaleas OR=1,73, IC (1,27-2,37). Un alto porcentaje de automedicación, datos similares a un estudio hecho en farmacéuticos y estudiantes de Ciencias de la Salud (38,5%). Asimismo, hay un alto riesgo en variables asociadas, concordante con estudios internacionales que señalan factores exógenos y factores endógenos asociados. Se concluye que existe alta prevalencia de automedicación y que los factores asociados (consumo de tabaco y alcohol) inciden en esta práctica. Se espera que se fomente la indagación en la salud del personal sanitario, garantizando la seguridad de las actividades y la impecabilidad en el ejercicio técnico profesional.

Resumo: O objetivo do estudo foi demonstrar a utilização de medicamentos não prescritos no, saúde / profissional técnica administrativa e fatores associados. Corresponde a um desenho transversal de 182 profissionais e 578 técnicos/administrativos. análise descritiva e inferencial foi realizada com o nível de significância de 5%. É aprovado pela Comissão de Ética e consentimento informado. 44,9% foi obtido que apresenta o consumo de medicamentos, comparando situação profissional tem OR = 1,66, CI (1,18-2,32), o consumo de tabaco OR = 1,38, CI (1,02-1,87), em álcool OR = 2,10, CI (1,55-2,86), na hipertensão OR = 2,25 IC (1,29-3,91), e OR = 1,73 dores de cabeça, CI (1,27-2,37). Elevada percentagem de auto-medicação, semelhante a um farmacêutico de estudo e estudantes de Ciências da Saúde (38,5%) de dados. Além disso, elevado risco associado, variáveis ​​consistentes com estudos internacionais indicando factores exógenos associados e factores endógenos. Concluiu-se que uma elevada prevalência de auto-medicação e factores associados (consumo de tabaco e álcool), afectar esta prática. O inquérito está prevista para ser promovido a saúde dos trabalhadores de saúde, garantindo a segurança das atividades e impecabilidade em exercício técnico profissional.

Abstract: The objective of the study was to assess the situation of consumption of non-prescribed drugs by health professionals, technical/administrative staff and its associated factors. It corresponds to a cross-sectional design in 182 professionals and 578 technicians/ administratives. A descriptive and inferential analysis was performed, with a significance level of 5%. The Committee on Ethics and Informed Consent has approved this study. It was obtained that 44.9% consumed non-prescribed medication, when comparing with professional situation, OR = 1.66, CI (1.18-2.32); in tobacco consumption OR = 1.38, CI 1.02-1.87); in alcohol consumption OR = 2.10, CI (1.55-2.86); in arterial hypertension OR = 2.25 CI (1.29-3.91), and in headaches OR = 1.73, CI (1.27-2.37). A high percentage of self-medication is shown, data similar to a study performed in pharmacists and students of Health Sciences (38.5%). There is also a high risk in associated variables, consistent with international studies that point out exogenous factors and associated endogenous factors. It is concluded that there is a high prevalence of self-medication and that the associated factors (smoking and alcohol consumption) influence this practice. It is hoped that the investigation into the health status of health professionals will be promoted, thus guaranteeing the safety of their activities and the impeccability in the practice of the profession.

Using course survey feedback to encourage learning and concept application in a self-care and nonprescription medications course.

OBJECTIVE: To improve student application of course content and learning in a self-care and nonprescription medications course. DESIGN: A precourse survey was administered to students to determine confidence in their ability to advise patients about nonprescription medications and to identify what they would like to learn in the course. Data gathered from the precourse survey was then used to modify course content. A postcourse survey was conducted to encourage students to reflect on course concepts and apply them in practice or when advising friends and family members about nonprescription drugs and self-care. ASSESSMENT: Comparison of precourse and postcourse responses showed an increase in students' confidence in their ability to provide nonprescription medication advice. Postcourse qualitative responses described student application of class concepts in providing self-care education and advice. Course and course director evaluations were positive. CONCLUSION: Course surveys can be a useful strategy for encouraging students to think about how they may practically apply course concepts, bridging the gap between theory and practice.

Audio taping simulated patient encounters in community pharmacy to enhance the reliability of assessments.

OBJECTIVES: To assess whether audio taping simulated patient interactions can improve the reliability of manually documented data and result in more accurate assessments. METHODS: Over a 3-month period, 1340 simulated patient visits were made to community pharmacies. Following the encounters, data gathered by the simulated patient were relayed to a coordinator who completed a rating form. Data recorded on the forms were later compared to an audiotape of the interaction. Corrections were tallied and reasons for making them were coded. RESULTS: Approximately 10% of cases required corrections, resulting in a 10%-20% modification in the pharmacy's total score. The difference between postcorrection and precorrection scores was significant. CONCLUSIONS: Audio taping simulated patient visits enhances data integrity. Most corrections were required because of the simulated patients' poor recall abilities.