Pharmacy customers’ knowledge of side effects of purchased medicines in Mexico

Medicines policy, access and use in Mexico: a systematic literature review 2000-2022

Background

Research on medicines access and use is heterogeneous and can be challenging for decision-makers to interpret. Pharmaceutical policy is an additional component for study and is the foundation for the promotion of access and use of medicines. This systematic review summarizes findings from the literature on medicines policy, access and use over the past two decades in Mexico and identifies research gaps that should be addressed.

Methods

A systematic review of the literature published between 2000 and 2022 was conducted to identify publications on medicines policy, access and use in Mexico. The study followed PRISMA Statement guidelines 2020. A narrative review including content analysis was conducted.

Results

A total of 5057 articles were reviewed, of which 77 fit the inclusion criteria. Studies described the lack of an explicit national policy, a misalignment between the legal framework and reinforcement incentives, deficient policy documentation at the national level, and the absence of necessary medicines regulation and transparency. In terms of access to medicines, challenges related to supply, selection, acquisition, distribution and expenditure were noted. Regarding medicine use, key study findings included a lack of adherence to standard treatment guidelines, dispensing, lack of reliable information on medicines, lack of treatment adherence and harmful self-medication.

Conclusion

The appropriate use of medicines and adequate access to them are priority topics for the formulation of Mexican pharmaceutical policy. It is critical that further research includes longitudinal studies of medicine access and use, and the consideration of studying the private sector as well as new methodological approaches. Many reported challenges related to access to and use of medicines have persisted across decades, suggesting a lack of effective research-to-practice knowledge transfer and policy implementation.This article is part of the Hospital pharmacy, rational use of medicines and patient safety in Latin America Special Issue: https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/.

Frequency and Knowledge of Analgesics Self-Use and Their Adverse Effects in the Eastern Province of Saudi Arabia

Background Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used over-the-counter (OTC) medications, both locally in Saudi Arabia (SA) and globally. They are widely available and can be easily obtained; however, the potential health risks of these drugs are well-documented. This study aimed to measure the frequency of analgesics' self-use and assess the general population's knowledge of their adverse effects. Methodology This is a descriptive, cross-sectional study that was conducted through an online self-administered questionnaire. It targeted adults who are non-healthcare professionals living in the eastern province of SA. Results The sample consisted of 345 participants, of which 196 (56.8%) were male and 149 (43.2%) were female. The most self-used medication was paracetamol at 91%, followed by ibuprofen at 38.8%. Although the prevalence of self-use was high, a low frequency of repeated use was evident, as 49.3% of the participants rarely used them and 19.4% used them only every few months. There was a significant association between the female gender, lower levels of education, and a higher frequency of repeated use of analgesics. About 54.5% of the participants recognized three side effects or fewer, while 90 (26.1%) of them showed knowledge about four to six side effects. Conclusions Considering that paracetamol and NSAIDs are easily procurable OTC, the knowledge of the general population about their harmful adverse effects needs to be enhanced, specifically that of the most vulnerable patient groups.

I. INTRODUCTION: UNDERSTANDING MEDICINES AND MEDICAL INTERVENTIONS

We live in an increasingly pharmacological and medical world, where children and adults frequently encounter alleged treatments for an enormous range of illnesses. How do we come to understand what heals and why? Here, 15 studies explore how 1,414 children (ages 5-11) and 882 adults construe the efficacies of different kinds of cures. Developmental patterns in folk physics, psychology, and biology lead to predictions about which expectations about cures will remain relatively constant across development and which will change. With respect to stability, we find that even young school children (ages 5-7) distinguish between physical and psychological disorders and the treatments most effective for each. In contrast, young children reason differently about temporal properties associated with cures. They often judge that dramatic departures from prescribed schedules will continue to be effective. Young children are also less likely than older ages to differentiate between the treatment needs of acute versus chronic disorders. Young children see medicines as agent-like entities that migrate only to afflicted regions while having "cure-all" properties, views that help explain their difficulties grasping side effects. They also differ from older children and adults by judging pain and effort as reducing, instead of enhancing, a treatment's power. Finally, across all studies, optimism about treatment efficacy declines with age. Taken together, these studies show major developmental changes in how children envision the ways medicines work in the body. Moreover, these findings link to broader patterns in cognitive development and have implications for how medicines should be explained to children.

Users' Knowledge About Adverse Effects of Non-steroidal Anti-inflammatory Drugs in Tirana, Albania

Aim:

To assess the level of knowledge of the adult users of non-steroidal anti-inflammatory drugs (NSAIDs) regarding their side effects and the socio-demographic factors associated with the use of these drugs in the adult population of Albania.

Methods:

This was a cross-sectional study including a representative sample of 199 individuals aged ≥18 years (77% women; overall mean age: 30.3±10.0 years; overall response rate: 90%) who were users of NSAIDs recruited in ten different pharmacies in Tirana municipality during April-May 2015. A self-administered questionnaire contained basic socio-demographic information and questions about NSAIDs use, their types, participants’ knowledge about NSAIDs side effects and their interaction with other drugs.

Results:

In 56% of the cases, NSAIDs were taken by participants’ own decisions, whereas in about 29% of the cases these drugs were prescribed by physicians. Acetaminophen, ketoprofen and ibuprofen were the most frequently used NSAIDs. Overall, 51% of participants thought NSAIDs could cause allergic reactions, whereas one third or fewer were aware of each of the following side effects: upper and lower gastrointestinal bleeding, hypertension, gastritis, kidney failure, myopathy, osteoporosis. About one third of participants were aware of NSAIDs-other drug interactions, whereas some of them were already taking contraindicated drugs. No significant differences were noticed regarding sex, age, educational level, employment status and marital status, with very few exceptions.

Conclusion:

Our findings indicate limited knowledge about NSAIDs side effects and their interaction with other drugs among the Albania adult population, which is a cause of concern.

Customers' perceptions of and satisfaction with medicine retail outlet services in Addis Ababa, Ethiopia: a cross-sectional study

OBJECTIVES

The aim of this study was to assess customers' perceptions of and satisfaction with MRO services in Addis Ababa and to explore factors associated with their satisfaction and reasons for visits.

METHODS

A cross-sectional survey was conducted among customers selected from 28 MROs in Addis Ababa, using multi-stage sampling techniques. Simple descriptive statistics and multivariable logistic regression at 95% confidence interval were used for the analysis.

KEY FINDINGS

Of 396 respondents, 324 (81.8%) visited MROs to purchase prescription medicines. A majority (338/396; 85.4%) of them perceived that pharmacists and druggists (pharmacy professionals) play a major role in healthcare delivery. A third (140/396; 35.4%) of the respondents agreed with the statement that pharmacy professionals are more concerned about patient care than about their business. Regarding reasons for visiting, being married was positively associated with buying over-the-counter, higher educational status was linked with more satisfaction. Overall, 56.8% (225/396) of the respondents reported that they were satisfied with the service provided by MROs.

CONCLUSION

Customers of MROs had mixed perceptions of and satisfaction with the current service. Marital status and age were associated with the reason for visiting, while the educational level was associated with the level of satisfaction. The overall positive perceptions and satisfaction about MROs should be taken as an opportunity to promote and improve pharmaceutical services rendered in MROs, to ensure that the public is receiving maximum benefit.

Lost in translation: Medication labeling for immigrant families

OBJECTIVES

To identify the patient-safety hazards of current medication labeling standards for immigrant and language-minority families.

SUMMARY

The Latino population in the United States has increased by more than 40% over the past decade and the total child population born to Latino parents will surpass one-half of the population in many states. With recent health care and immigration policies, this demographic shift has a disproportional effect on the Latino families. Research shows that recent Latin American immigrants face disparities when encountering the U.S. pharmacy system. A review of these disparities shows how new policies should be informed when considering new pharmacy regulations to better address the cultural needs of recent Latin American families to improve medication understanding and adherence.

CONCLUSION

To date, research and regulatory requirements for medication safety in the United States have attended insufficiently to the patient-safety risk inherent in providing complex English-language labels to non-English-speaking families, many of whom have limited literacy in their native language. As families move, this patient-safety risk is increased by shifts in pharmacies, which often have different medication-labeling standards. It is important to examine how recent immigrant parents are addressing the medication needs for their children based on their cultural norms and how those cultural practices and acculturation into the U.S. health care system may affect their risk for injury. New research and policy efforts may help to address these barriers to safe medication use.

Safety concerns in simultaneous use of prescription and 'over-the-counter' medicines- results of patient survey in Estonia

During the last decades, the share of population using prescription (Rx) medicines has considerably increased. With the wider introduction of self-medication and the use of over-the-counter (OTC) medicines, there is a real threat for drug-drug interactions between Rx and OTC medicines neither identified nor overseen by healthcare specialists.

The objectives of this survey were to ascertain how often, and for what conditions OTC and Rx medicines are used simultaneously, and to discuss possible health hazards connected with the concomitant use of these medicines.

This survey was designed as a descriptive, cross-sectional questionnaire-based interview which was conducted amongst pharmacy customers and patients in urban and rural areas of Estonia in between 2010–2012.

In total, 712 respondents participated in the survey. Of those, 50.4% reported concomitant use of Rx and OTC medicines during the survey. The simultaneous use of Rx and OTC medicines increased with age and the number of chronic diseases (both p < 0.001). Of chronic patients, 37.1% used Rx and OTC medicines on a daily basis over a four-week period before the survey, and considering reported chronic diseases and the most widespread OTC medicines, they could encounter drug-drug interactions between Rx medicines (e.g. antihypertensives, anti-inflammatory medicines) and OTC medicines (e.g. paracetamol, NSAID-s, herbal medicines and adsorbents).

The present survey revealed frequent concomitant use of Rx and OTC medicines. Especially vulnerable are chronic and elderly patients. In the future, both patients and healthcare specialists should pay more attention to possible drug-drug interactions of Rx and OTC medicines.

Molecular epidemiology of Escherichia coli O25b-ST131 isolates causing community-acquired UTIs in Mexico

Escherichia coli is a common uropathogen causing community-acquired urinary tract infections (UTIs). Out of 4735 E. coli community-acquired UTIs, 10.2% were extended spectrum β-lactamases (ESBL)-producing. The identified ESBL types were CTX-M-15 (96.4%), SHV-2a (3%), and TLA-1 (1%). Of the isolates, 94.6% tested positive for plasmid-mediated quinolone resistance (PMQR) genes (aac(6')-lb-cr [92.1%] and qepA1 [7%] and for qnr-determinants [3.5%]). E. coli O25b-ST131 was identified in 25% of the isolates that harbor a non-conjugative 160-kb plasmid (IncFIA) containing the CTX-M-15, and all of these isolates were found to contain PMQR genes. This work can be useful in modeling the potential impact that may have on community-acquired UTIs in Mexico.