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Yang Z, Han X, Yang C, Zhao Y, Li C, Zhu Q, Xue Q, Zhang Y, Li G, Jiang B. Storage practice and wastage of pharmaceuticals in Chinese urban-dwelling households: Description of urban-dwelling households. Public Health Nurs 2024. [PMID: 39344285 DOI: 10.1111/phn.13401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/23/2024] [Accepted: 08/15/2024] [Indexed: 10/01/2024]
Abstract
At-home storage of medications could pose a threat to public health and the environment if not handled appropriately. Excessive storage also creates health care and economic burdens. This study investigated storage practices, waste, and their determinants in China. Data were collected by pharmacy staff of urban-dwelling households via online questionnaires. Descriptions at the household and medicine levels were conducted in Stata 16. Individual and family characteristics were associated with the presence of household medicine storage (84.6%, n = 5290), but storage location was poor. Expiration was the primary reason for discarding medicines. Respondents were inclined to buy medicines in pharmacies without prescription for storage purposes at out-of-pocket expenses, and 60.7% of medicines were purchased at out-of-pocket expenses, despite medical insurance coverage. Regarding wastage, 11.2% of medicines had expired and 38.2% were no longer needed. Purchasing for storage purposes was related to less waste due to expiration, while purchasing for treating acute diseases rather than chronic diseases was related to more waste, due to less for use. Accounting for 12.2% of all medications, antibiotics were associated with expiration and no further need for use. Source-control measures targeting health facilities, pharmacies, and residents are needed under the combined efforts of all relevant departments.
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Affiliation(s)
- Zhao Yang
- Center for Digital Health and Artificial Intelligence, Peking University First Hospital, Beijing, China
| | - Xiao Han
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
| | - Chao Yang
- Center for Digital Health and Artificial Intelligence, Peking University First Hospital, Beijing, China
| | - Yue Zhao
- School of Pharmaceutical Sciences, Health Science Center, Peking University, Beijing, China
| | - Chengyu Li
- School of Business Administration, Liaoning Technical University, Liaoning, China
| | - Qiyun Zhu
- Revelle College, University of California San Diego, San Diego, California, USA
| | - Qingyuan Xue
- Public Policy Research Center, Peking University, Beijing, China
| | - Yaoguang Zhang
- National Health Commission Information Center, Beijing, China
| | - Guohong Li
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
| | - Bin Jiang
- School of Pharmaceutical Sciences, Health Science Center, Peking University, Beijing, China
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Al Ghadeer HA, Alnajjar JS, Aldandan JK, Bokhamseen AA, Al Dandan AM, Almarzoq MA, Alnajjar HJ, Albuti AH, Almuhaini MA, Alsalman MA, Al Sabah SA. Prevalent Parental Practice Toward Drug Storage and Disposal. Cureus 2024; 16:e60449. [PMID: 38883089 PMCID: PMC11179737 DOI: 10.7759/cureus.60449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction The environment, healthcare services, and public safety can all be directly impacted by improper drug storage and disposal practices. It is unknown whether parents store drugs at home in accordance with recommended storage guidelines, despite the fact that storage conditions are strictly regulated and monitored at every stage of the drug supply chain prior to drug dispensing. Therefore, it is crucial to dispose of medications properly and store them at home to avoid the consequences. Aim The purpose of this study was to evaluate the drug storage safety measures used by parents to prevent unintentional drug poisoning in children. Methodology A structured questionnaire was used to conduct a cross-sectional, interview-based study on home medication storage, attitudes, and disposal practices between October 2023 and January 2024. We recruited parents who visited primary healthcare centers or pediatric clinics using a convenience sampling technique. Results All of the 353 returned questionnaires were valid for data entry and analysis. The mean age of the parents was 35.1 ± 11.9 years old and more than half of them 229 (64.9%) have bachelor's degrees. The majority of drugs (271, 88.6%) were stored in the fridge, followed by bedrooms (26.8%). The medication classes that were stored the most frequently were analgesics (92.2%) and antihistamines (62.1%). The majority of parents (214, 69.9%) kept medications above adult eye level, even though only 28% did not keep them in safe and secure locations like locked drawers or boxes. Eighty percent (80%) disposed of unwanted medicines by throwing them in the trash, and only 10 (2.8%) returned them to the pharmacy. Conclusions Drug storage at home encourages self-medication, which has a number of negative effects. Over time, there has been an increase in the use of medications due to a rise in people's health-seeking awareness and behavior on a global scale. Therefore, this study may be used as a guide by national policy-makers for pharmaceutical disposal and storage management. Moreover, it might help in raising public awareness of the importance of pharmacists in the society and the safe handling and storage of medications at home.
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Affiliation(s)
| | | | | | | | | | | | | | - Ali H Albuti
- College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | - Shifa A Al Sabah
- Nursing, Primary Health Care, Al-Ahsa Health Cluster, Al-Ahsa, SAU
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Gascón P, Harbeck N, Rapoport BL, Anderson R, Brueckmann I, Howe S, Aapro M. Filgrastim biosimilar (EP2006): A review of 15 years' post-approval evidence. Crit Rev Oncol Hematol 2024; 196:104306. [PMID: 38401695 DOI: 10.1016/j.critrevonc.2024.104306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024] Open
Abstract
Filgrastim is approved for several indications, including reduction of the incidence and duration of chemotherapy-induced neutropenia and for stem cell mobilization. The filgrastim biosimilar, EP2006, has been available in Europe since 2009, and in the United States since 2015. In this time, preclinical and clinical data used to support the approval of EP2006 have been published. These data established the biosimilarity of EP2006 to reference filgrastim in terms of structure, pharmacokinetics, pharmacodynamics, efficacy, safety, and immunogenicity. Additional real-world evidence studies have also demonstrated equivalent efficacy and safety of EP2006 compared with reference filgrastim, both in the reduction of neutropenia and in stem cell mobilization in clinical practice. This review summarizes these preclinical, clinical, and real-world data, as well as the available cost-effectiveness data, for EP2006 since its approval 15 years ago.
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Affiliation(s)
- Pere Gascón
- Division of Medical Oncology, IDIBAPS, Hospital Clinic, Casanova 143, Barcelona 08036, Spain
| | - Nadia Harbeck
- Breast Center, Department OB&GYN and Center for hereditary Breast and Ovarian Cancer, LMU University Hospital, Marchioninistraße 15, Munich 81377, Germany
| | - Bernardo L Rapoport
- The Medical Oncology Centre of Rosebank, 129 Oxford Road, Johannesburg 2196, South Africa; Department of Immunology, Pathology Building, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Ronald Anderson
- Department of Immunology, Pathology Building, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Ines Brueckmann
- Sandoz Group AG, Global Medical Affairs, Industriestr. 25, Holzkirchen D-83607, Germany
| | - Sebastian Howe
- Sandoz Group AG, Global Medical Affairs, Industriestr. 25, Holzkirchen D-83607, Germany.
| | - Matti Aapro
- Cancer Center, Clinique de Genolier, Route du Muids 3, Genolier 1272, Switzerland
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Meisner M, Sarecka-Hujar B. Assessment of Directional-Hemispherical Reflectance of Tablets with Cefuroxime during Storage under Elevated Temperature and Ultraviolet Radiation. SENSORS (BASEL, SWITZERLAND) 2024; 24:630. [PMID: 38276321 PMCID: PMC10821049 DOI: 10.3390/s24020630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Environmental conditions can lead to changes in the physical and chemical structures of drug products. In this study, the stability of cefuroxime tablets stored under adverse conditions was evaluated based on total directional-hemispherical reflectance (THR). The THR value was measured before and after the tablets' exposure to stress factors (temperature of 45 °C and UV radiation). Each measurement was performed three times within seven spectral bands at the beginning of the experiment (day 0), and then on days 1, 2, 3, 5, and 7. In addition, hyperspectral profiles (400-1030 nm) were analyzed on days 0 and 7. A significant decrease in THR values in all wavelength ranges was observed when day 7 vs. day 0 were compared, especially for spectral bands of 335-380 nm and 1700-2500 nm (Δ = 0.220, p < 0.001 and Δ = 0.171, p < 0.001, respectively). The hyperspectral analysis confirmed a decrease in the reflectance after the end of stress conditions in the visible light range (400-700 nm) compared to tablets before the experiment. This may indicate that more radiation entered the tablets. In conclusion, the THR of cefuroxime tablets decreases during the exposure to heat and UV radiation, which may result from some physicochemical changes that have occurred during storage.
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Affiliation(s)
- Michał Meisner
- Doctoral School, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland
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Mortelmans L, Goossens E, De Cock AM, Petrovic M, van den Bemt P, Dilles T. The Development of Recommendations for Healthcare Providers to Support Patients Experiencing Medication Self-Management Problems. Healthcare (Basel) 2023; 11:healthcare11111545. [PMID: 37297685 DOI: 10.3390/healthcare11111545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Medication self-management problems such as the inability to correctly obtain, understand, organize, administer or monitor medication can result in negative patient outcomes. However, supportive tools for healthcare providers to assist patients with medication self-management problems are lacking. This study aimed to develop recommendations for healthcare providers to support patients with polypharmacy who experience medication self-management problems. A three-phase study was conducted starting with (1) the mapping of medication self-management problems, followed by (2) a scoping review providing a list of relevant interventions and actions for each respective problem and (3) a three-round modified e-Delphi study with experts to reach consensus on the relevance and clarity of the recommended interventions and actions. The cut-off for consensus on the relevance and clarity of the recommendations was set at 80% expert agreement. Experts could propose additional recommendations based on their professional experience and expertise. The experts (n = 23) involved were healthcare professionals (i.e., nurses, pharmacists, and physicians) with specific expertise in medication management of patients with polypharmacy. Simultaneous with the second e-Delphi round, a panel of patients with polypharmacy (n = 8) evaluated the usefulness of recommendations. Results obtained from the patient panel were fed back to the panel of healthcare providers in the third e-Delphi round. Descriptive statistics were used for data analysis. Twenty medication self-management problems were identified. Based on the scoping review, a list of 66 recommendations for healthcare providers to support patients with the identified medication self-management problems was composed. At the end of the three-round e-Delphi study, the expert panel reached consensus on the relevance and clarity of 67 recommendations, clustered according to the six phases of the medication self-management model by Bailey et al. In conclusion, this study resulted in a guidance document including recommendations that can serve as a resource for healthcare providers to support patients with polypharmacy in case of medication self-management problems. Future research should focus on the evaluation of the feasibility and user-friendliness of the guide with recommendations in clinical practice.
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Affiliation(s)
- Laura Mortelmans
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing Science and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Eva Goossens
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing Science and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- Department of Patient Care, Antwerp University Hospital (UZA), 2610 Antwerp, Belgium
| | - Anne-Marie De Cock
- Department of Geriatrics, ZNA, 2020 Antwerp, Belgium
- Department of Family Medicine and Population Health, University of Antwerp, 2610 Antwerp, Belgium
| | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, 9000 Ghent, Belgium
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, 9000 Ghent, Belgium
| | - Patricia van den Bemt
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Tinne Dilles
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing Science and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
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Discrete Choice Experiment to Understand Japanese Patients' and Physicians' Preferences for Preventive Treatments for Migraine. Neurol Ther 2023; 12:651-668. [PMID: 36848008 PMCID: PMC10043145 DOI: 10.1007/s40120-023-00453-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION Self-injectable calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) auto-injectors and non-CGRP oral medications are currently available for migraine prevention in Japan. This study elicited the preferences for self-injectable CGRP mAbs and non-CGRP oral medications and determined differences in the relative importance of auto-injector attributes for patients and physicians in Japan. METHODS Japanese adults with episodic (EM) or chronic (CM) migraine and physicians who treat migraine completed an online discrete choice experiment (DCE), asking participants to choose a hypothetical treatment they preferred between two self-injectable CGRP mAb auto-injectors and a non-CGRP oral medication. The treatments were described by seven treatment attributes, with attribute levels varying between questions. DCE data were analyzed using a random-constant logit model to estimate relative attribution importance (RAI) scores and predicted choice probabilities (PCP) of CGRP mAb profiles. RESULTS A total of 601 patients (79.2% with EM, 60.1% female, mean age: 40.3 years) and 219 physicians (mean length of practice: 18.3 years) completed the DCE. About half (50.5%) of patients favored CGRP mAb auto-injectors, while others were skeptical of (20.2%) or averse (29.3%) to them. Patients most valued needle removal (RAI = 33.8%), shorter injection duration (RAI = 32.1%), and auto-injector base shape and need for skin pinching (RAI = 23.2%). Most physicians (87.8%) favored auto-injectors over non-CGRP oral medications. Physicians most valued less-frequent dosing RAI = 32.7%), shorter injection duration (30.4%), and longer storage outside the fridge (RAI = 20.3%). A profile comparable to galcanezumab showed a higher likelihood of being chosen by patients (PCP = 42.8%) than profiles comparable to erenumab (PCP = 28.4%) and fremanezumab (PCP = 28.8%). The PCPs of the three profiles were similar among physicians. CONCLUSION Many patients and physicians preferred CGRP mAb auto-injectors over non-CGRP oral medications and preferred a treatment profile similar to galcanezumab. Our results may encourage physicians in Japan to consider patient preferences when recommending migraine preventive treatments.
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Gualtieri L, Shaveet E, Estime B, Patel A. The role of home medication storage location in increasing medication adherence for middle-aged and older adults. Front Digit Health 2022; 4:999981. [PMID: 36405415 PMCID: PMC9671937 DOI: 10.3389/fdgth.2022.999981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Over 50% of US adults do not take their prescriptions as prescribed, which is responsible for 33%–69% of hospital admissions and 125,000 deaths annually. Given the higher prevalence of prescription drug use among middle-aged and older adult populations, promoting medication adherence is of particular importance with these age groups. Two speculated facilitators of medication adherence are home medication storage location and the use of digital health devices. Objective Our objective was to use survey data to investigate the associations between medication storage location and medication adherence among adults 40 years and older. Additionally, we aimed to report preliminary findings about the associations between use of devices and medication adherence in this same population. Methods We conducted primary analysis of data sampled from a home medication management survey deployed in November 2021 (n = 580). We conducted exploratory analyses by way of chi2 tests and creation of bivariate logistic regression models. Results The most commonly used storage locations by our sample were nightstand drawers (27%), kitchen cabinets (25%), and atop bedroom nightstands (23%). Several medication storage locations were significantly associated with decreased odds of having ever forgotten to take a medication, including kitchen drawers, in refrigerators, atop bedroom nightstands, in nightstand drawers, and backpacks, purses, or bags. Two home medication storage locations were significantly associated with increased odds of having ever forgotten to take a medication: kitchen cabinets and bathroom vanities. Further, most (94%) survey respondents indicated they would be receptive to guidance about where to store their medications. Conclusions Given that some home medication storage locations are associated with adherence, an intervention to guide storage location selection may support increased adherence, especially with high receptivity expressed for such guidance. Increased adherence may also accrue from device usage paired with optimized home medication storage location. We plan to investigate that further, as well as how new device designs can incorporate contextual cues related to location to promote medication adherence more effectively in middle aged and older adults.
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Adherence to Therapy in Glaucoma Treatment—A Review. J Pers Med 2022; 12:jpm12040514. [PMID: 35455630 PMCID: PMC9032050 DOI: 10.3390/jpm12040514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022] Open
Abstract
Glaucoma is a chronic disease and the second leading cause of irreversible vision loss worldwide, whose initial treatment consists of self-administered topical ocular hypotensive eyedrops. Adherence with glaucoma medications is a fundamental problem in the care of glaucoma patients as up to 50% of patients fail to receive the intended benefits of the treatment. The literature has identified many barriers to patients’ compliance, from factors depending on the type of medication administered, communication between physician and patients, to factors dependent on patients’ behaviour and lifestyle. Failure to take medication as prescribed increases the risk that patients will not receive the desired benefit, which often leads to a worsening of the disease. Our aim is to synthesize the methods used for measuring adherence of patients to glaucoma therapy and the interventions used for addressing adherence, laying emphasis on a patient-centred approach, taking time to educate patients about their chronic disease and to assess their views on treatment.
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Faisal S, Ivo J, McMillan C, Grindrod K, Patel T. In-home medication management by older adults: a modified ethnography study using digital photography walkabouts. Age Ageing 2022; 51:6399894. [PMID: 34718366 DOI: 10.1093/ageing/afab207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medication mismanagement can lead to non-optimal management of chronic diseases and poor health outcomes. OBJECTIVE The purpose of this study was to better understand meanings associated with in-home medication management and storage practices of older adults with chronic diseases. METHODS A modified ethnographic approach using digital photography walkabouts, observation protocols and field notes were used to document in-home medication organisation and storage locations. Thematic analysis was used to generate themes and sub-themes. RESULTS Data from multiple home visits of 10 participants (mean age = 76 years; 80% females) including 30 photographs, 10 observation protocols and field notes were analysed. The average number of medications used was reported to be 11.1 (range: 5-20). Themes and sub-themes include choice of storage location (sub-themes: impact on medication behaviour, visibility of medications and storage with other items), knowledge regarding appropriate medication storage conditions (sub-themes: impact on safety of patient and impact on stability of medications) and systems to manage in-home medication intake. DISCUSSION In-home medication management reflects older adults perspectives regarding privacy, medication taking routine, knowledge about safe and effective storage and organisation systems. The lack of knowledge causing inappropriate medication storage not only impacts the stability of medications, but also increases risk of medication errors and safety, ultimately affecting medication intake behaviours.
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Affiliation(s)
- Sadaf Faisal
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Jessica Ivo
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Colleen McMillan
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
- Renison University College, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
- Schlegel – University of Waterloo Research Institute of Aging, Waterloo, Ontario, Canada
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
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Hendaus MA, Saleh M, Darwish S, Mostafa O, Eltayeb A, Al-Amri M, Siddiqui FJ, Alhammadi A. Parental perception of medications safe storage in the State of Qatar. J Family Med Prim Care 2021; 10:2969-2973. [PMID: 34660433 PMCID: PMC8483110 DOI: 10.4103/jfmpc.jfmpc_1259_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose of this study is to identify parental perception of household medication storage. METHODS A prospective cross-sectional study utilizing a questionnaire was carried out at Hamad Medical Corporation, the solely tertiary pediatric hospital in the State of Qatar at the time of the study. Qatar is a young developing country with limited data on the awareness of medication storage among adults with children at home and on the safety practices regarding medication storage. RESULTS Three hundred and five questionnaires were completed. The vast majority of parents were married, one-third of them were males, and more than three quarters were college graduates and younger than 40 years of age. Almost 80% of the parents had more than three children but less than seven. In addition, 23% of participants were health-care workers. Almost 90% of the participants stored medications in a place that is easy to reach. However, the same percentage stated that those medications were stored in a locked place and that children did not have access to them. Approximately 10% of caregivers store multiple medications in one bottle, and the same percentage of participants do not check the expiration date on the medication labels. In terms of the most common medications stored at home, antihypertensives were on top of the list. Our study has shown that parental education and being a health-care worker were each associated with the difficulty in reaching medications (P = 0.006 and P = 0.011, respectively). Moreover, the percentage of participants who shared medications was significantly higher among those who were not working in the health-care section compared to those who were (P = 0.004). In addition, being a female parent and a college graduate was associated with the possibility of keeping excess or leftover medications at home (P = 0.025). CONCLUSION Parents residing in the State of Qatar have some deficiencies in knowledge about medication storage. Parent's attitudes and perceptions are deemed vital objectives for population's health intervention.
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Affiliation(s)
- Mohamed A. Hendaus
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
| | - Manar Saleh
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Shereen Darwish
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Omar Mostafa
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Eltayeb
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Al-Amri
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | | | - Ahmed Alhammadi
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
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Funk OG, Yung R, Arrighi S, Lee S. Medication Storage Appropriateness in US Households. Innov Pharm 2021; 12. [PMID: 34345509 PMCID: PMC8326694 DOI: 10.24926/iip.v12i2.3822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background/Objective(s): Many people in the United States (US) store medications, both prescription and over-the-counter, in their households. They may store medications in a designated location which could pose some convenience for the ease of use and access. However, most people may not know if their medications are stored properly to maintain stability and sterility. The objective of this study is to assess the medication storage locations in US households and evaluate appropriateness for each reported stored medication based on the published literature and drug information databases. Methods: 195 US Qualtrics panel members completed the National Household Medication Survey about medications stored at home and the number of residents in the household. This survey was a cross-sectional, self-administered, online survey completed through Qualtrics. The reported medications and their corresponding storage locations were categorized based on their appropriateness with moisture/humidity, temperatures and accidental exposure to children. The number of medications stored appropriately per household was recorded based on published literature, Lexicomp, Nature Made and Nature’s Bounty were consulted. Results: 154 (79%) households completed the survey. 75 (38.4%) households had at least one resident younger than 18 years old. 72 (46.8%) households stored at least one medication on a countertop. Only 28 (23.3%) households stored all their medications appropriately, while 92 (76.7%) households were storing at least one medication inappropriately. 34 (22%) households reported medications that were unidentifiable or no medications at all. 457 medications were reported by the 154 households. 13 of the households did not store any medications at home. 162-164 (~35%) of the medications were stored appropriately. 52 to 54 (~11%) medications had a moisture/humidity issue, 77 to 79 (~17%) had a temperature issue, and 42 to 44 (~9%) medications had both issues. 23 (5%) medications had an issue with a potential risk for accidental exposure to children, 6 (1.3%) had issues with both risk for accidental exposure to children and moisture/humidity, 8 (1.8%) had issues with both risk for accidental exposure to children and temperature, and 4 (0.9%) medications shared all three issues. Some numbers are reported with a range because certain medications have different storage recommendations based on formulation, so if a formulation wasn’t specified, both storage recommendations were taken into consideration. Conclusion: The findings suggest that many US households may be storing medications in inappropriate locations. In order to ensure medication stability and sterility and reduce the risk of accidental ingestion, pharmacists should proactively educate patients on proper storage of their medications and signs of degradation to avoid undesirable effects from the medications.
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Affiliation(s)
- Olivia G Funk
- Long Island University Arnold & Marie Schwartz College of Pharmacy and Health Sciences
| | | | | | - SuHak Lee
- University of Minnesota College of Pharmacy
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12
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Warda N, Rotolo SM. Virtual medication tours with a pharmacist as part of a cystic fibrosis telehealth visit. J Am Pharm Assoc (2003) 2021; 61:e119-e125. [PMID: 33931355 PMCID: PMC8056476 DOI: 10.1016/j.japh.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023]
Abstract
Background As a result of the coronavirus disease 2019 (COVID-19) pandemic, institutions needed innovative solutions to provide care. With implementation of telehealth, a cystic fibrosis (CF) pharmacist was able to incorporate a virtual medication tour during appointments. Objective The purpose of our study was to describe the uptake and impact of pharmacist-led virtual medication tours during telehealth visits in the CF clinic setting. Practice description Before the COVID-19 pandemic, a CF pharmacist participated in in-person multidisciplinary team visits to complete medication history reconciliation, assess adherence, assess efficacy and address possible adverse effects of medications, and work collaboratively with the CF care team and patient to create therapeutic plans. The virtual medication tour described in this study was completed in addition or as a complement to these pre-existing pharmacist roles and responsibilities. Practice innovation Patients seen via telehealth visit were asked to provide a virtual tour of their medications. A pharmacist completed medication history and evaluated whether storage conditions were appropriate in regard to temperature, humidity, light exposure, and accessibility to children. Evaluation methods A pharmacist recorded findings from the virtual medication tours and made interventions when appropriate. Descriptive statistics were used for analysis. Results Of 20 patients seen via telehealth for a quarterly visit during the first 3 months after implementation, 13 were willing to participate in a virtual medication tour. Before the visit, 25% had information missing from their medication list. Virtual medication tour allowed for resolution of this information 80% of the time. Three of the 4 participating patients with a child under 12 years old had medications stored in a location accessible to children. Conclusion A virtual medication tour led by a pharmacist can be successfully incorporated into telehealth visits and was accepted by a majority of patients. Most patients stored medications appropriately but might benefit from education on poison prevention practices.
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Public Attitudes towards Medicinal Waste and Medicines Reuse in a 'Free Prescription' Healthcare System. PHARMACY 2021; 9:pharmacy9020077. [PMID: 33917990 PMCID: PMC8167727 DOI: 10.3390/pharmacy9020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigates public attitudes towards medicinal waste and medicines reuse within a ‘free prescription’ healthcare system. A quantitative online survey was employed in a sample drawn from the population of Wales, where prescription medicines have been ‘free’ since 2007. Qualitative interviews informed the content of the attitude statements with categorical or ordinal response options assigned. The questionnaire was hosted on the HealthWise Wales platform for 1 year from October 2017. Of the 5584 respondents, 67.2% had at least one medicine on repeat prescription. Overall, 89.1% held strong concerns about medicinal waste. High acceptance for the reuse of prescription medicines which have been returned unused by patients to pharmacies was reported for tablets (78.7%) and capsules (75.1%) if the medicine is checked by a pharmacist first (92.4% rated essential). Concerns identified related to tampering of packs (69.2%) and the need for hygienic storage (65.4%). However, those working in healthcare had less concern about the safety of reusing medicines. The level of public acceptance for the reuse of medication was higher than previously reported. This is the largest survey to capture these views to date, which has implications for the future design of medicines reuse schemes.
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Wilcox H, Carr C, Seney S, Reid G, Burton JP. Expired probiotics: what is really in your cabinet? FEMS MICROBES 2020. [DOI: 10.1093/femsmc/xtaa007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
ABSTRACT
The popularity of using probiotics has surged, since they became widely accepted as safe and help improve general health. Inevitably, some of these products are used after expiration when microbial cell viability is below the recommended effective dose. Given that probiotics must be live microorganisms administered in adequate amounts, the aim of this study was to measure viability in expired products and assess how packaging and storage conditions impact efficacy, if at all. Thirty-three expired probiotic products were evaluated, of which 26 were stored in conditions recommended by the manufacturer. The viable microbial cells were enumerated and representative isolates identified by 16S and internally transcribed spacer rRNA gene sequencing. While the products had a mean past expiration time of 11.32 (1–22) years, 22 still had viable contents, and 5 were within or above the original product cell count claim. Product formulation and the number of species present did not appear to impact the stability of the products. However, overall packaging type, storage conditions and time since expiry were found to affect viability. All products with viable cells had the strain stipulated on the label. Despite some selected probiotic products retaining viability past their expiry date (indicating long-term storage is possible), the total counts were mostly well below that required for efficacious use as recommended by the manufacturer. Consuming expired probiotics may not yield the benefits for which they were designed.
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Affiliation(s)
- Hannah Wilcox
- Department of Microbiology and Immunology, University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
- Canadian Centre for Human Microbiome and Probiotics, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada
| | - Charles Carr
- Canadian Centre for Human Microbiome and Probiotics, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada
| | - Shannon Seney
- Canadian Centre for Human Microbiome and Probiotics, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada
| | - Gregor Reid
- Department of Microbiology and Immunology, University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
- Canadian Centre for Human Microbiome and Probiotics, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada
| | - Jeremy P Burton
- Department of Microbiology and Immunology, University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
- Canadian Centre for Human Microbiome and Probiotics, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada
- Division of Urology, Department of Surgery, Schulich School of Medicine, LHRI, 268 Grosvenor St. London, ON, N6A 4V2 CANADA
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15
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Dijkstra NE, Sino CGM, Schuurmans MJ, Schoonhoven L, Heerdink ER. Medication self-management: Considerations and decisions by older people living at home. Res Social Adm Pharm 2020; 18:2410-2423. [PMID: 33627223 DOI: 10.1016/j.sapharm.2020.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 08/24/2020] [Accepted: 09/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Medication self-management is complicated for older people. Little is known about older persons' considerations and decisions concerning medication therapy at home. OBJECTIVE (s): To explore how older people living at home self-manage their medication and what considerations and decisions underpin their medication self-management behavior. METHODS Semi-structured interviews with consenting participants (living at home, aged ≥65, ≥5 different prescription medications daily) were recorded and transcribed with supporting photographs. Content was analyzed with a directed approach and presented according to three phases of medication self-management (initiation, execution, and discontinuation). RESULTS Sixty people were interviewed. In the initiation phase, participants used different techniques to inform healthcare professionals and to fill and check prescriptions. Over-the-counter medication was seldom discussed, and potential interactions were unknown to the participants. Some participants decided to not start treatment after reading the patient information leaflets for fear of side effects. In the execution phase, participants had various methods for integrating the use of new and chronic medication in daily life. Usage problems were discussed with healthcare professionals, but side effects were not discussed, since the participants were not aware that the signs and symptoms of side effects could be medication-related. Furthermore, participants stored medication in various (sometimes incorrect) ways and devised their own systems for ordering and filling repeat prescriptions. In the discontinuation phase, some participants decided to stop or change doses by themselves (because of side effects, therapeutic effects, or a lack of effect). They also mentioned different considerations regarding medication disposal and disposed their medication (in)correctly, stored it for future use, or distributed it to others. CONCLUSIONS Participants' considerations and decisions led to the following: problems in organizing medication intake, inadequate discussion of medication-related information with healthcare professionals, and incorrect and undesirable medication storage and disposal. There is a need for medication self-management observation, monitoring, and assistance by healthcare professionals.
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Affiliation(s)
- Nienke E Dijkstra
- Julius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Universiteitsweg 100, 3584, CG, Utrecht, the Netherlands; Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, CS, Utrecht, the Netherlands; Research Group Innovation in Pharmaceutical Care, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, CS, Utrecht, PO Box 12011, 3501, AA, Utrecht, the Netherlands.
| | - Carolien G M Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, CS, Utrecht, the Netherlands.
| | - Marieke J Schuurmans
- Education Center, University Medical Center Utrecht, Utrecht University, Utrecht, Hijmans van Den Bergh Building, 3508, GA, Utrecht, the Netherlands.
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Universiteitsweg 100, 3584, CG, Utrecht, the Netherlands; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, United Kingdom.
| | - Eibert R Heerdink
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584, CS, Utrecht, the Netherlands; Research Group Innovation in Pharmaceutical Care, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, CS, Utrecht, PO Box 12011, 3501, AA, Utrecht, the Netherlands.
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16
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Vlieland ND, van den Bemt BJF, Wouters H, Egberts ACG, Bouvy M, Gardarsdottir H. Associations between personality traits and adequate home storage of drugs in older patients. PSYCHOL HEALTH MED 2019; 24:1255-1266. [PMID: 31283357 DOI: 10.1080/13548506.2019.1634822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objective of this study was to investigate the association between personality traits of older patients and adequate home storage of drugs. Forty-four participating Dutch community pharmacists randomly selected each up to four community-dwelling elderly patients (≥65 years) who were using at least one prescription drug. The Big Five Inventory was used to assess the personality traits - 'openness', 'conscientiousness', 'extraversion', 'agreeableness' and 'neuroticism' - of patients. An assessment of adequate home storage of drugs was made using a summed composite score for each patient ranging from zero (adequate storage) to three (inadequate storage) was based on storage criteria representing quality, information and level of storage organization. A 51.2% of the patients stored drugs adequately in accordance with all quality ("Q") and information ("I") criteria. A high level of drug storage organization was found in 70.8% of patients. Forty-three patients (31.4%) stored their drugs adequately based on all storage criteria (composite storage score 0). No associations between personality dimensions and adequate drug storage were found. Having a lower number of drugs was associated with adequate drug home storage (ORadjusted 0.86; 95% CI: 0.77-0.96). In conclusion, this study suggests that personality is not associated with adequate home storage of drugs in older patients.
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Affiliation(s)
- N D Vlieland
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht , Utrecht , The Netherlands
| | - B J F van den Bemt
- Department of Pharmacy, Sint Maartenskliniek , Nijmegen , The Netherlands.,Department of Pharmacy, Radboud Medical Center , Nijmegen , The Netherlands.,Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center , Maastricht , The Netherlands
| | - H Wouters
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - A C G Egberts
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht , Utrecht , The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht , The Netherlands
| | - Marcel Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht , The Netherlands
| | - H Gardarsdottir
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht , Utrecht , The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht , The Netherlands.,Faculty of Pharmaceutical Sciences, University of Iceland , Reykjavik , Iceland
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