Status of self-medication and the relevant factors regarding drug efficacy and safety as important considerations among adolescents aged 12-18 in China: a cross-sectional study

The objective of this study was to investigate self-medication behavior among Chinese adolescents aged 12-18 years and explore the factors associated with whether adolescents prioritize drug efficacy or safety when engaging in self-medication behavior. In 2021, a questionnaire investigation was conducted in the Chinese mainland using a multi-stage sampling approach. After a statistical description, logistic regression was used to analyze the factors associated with considering drug efficacy and safety. The self-medication rate among Chinese adolescents aged 12-18 years was 96.61%. Of these, 65.84% considered drug safety to be essential, while 58.72% prioritized drug efficacy. Regression analysis showed that individuals with better healthcare were more likely to consider drug efficacy an important factor. Additionally, those with a healthier family lifestyle were more likely to prioritize efficacy. When individuals engage in self-medication, those residing in urban areas and possessing advanced preventive health literacy and ample family health resources tend to prioritize drug safety to a greater extent. Conversely, those with higher monthly household incomes and only children exhibit a decreased inclination towards prioritizing safety during self-medication. Self-medication is a frequently observed practice among Chinese adolescents aged 12-18. Several factors, such as demographic and sociological characteristics, health literacy, and family health status, have been found to be associated with the extent to which adolescents prioritize medication safety and efficacy when engaging in self-medication practices. Higher levels of health literacy and better family health status were positively correlated with considering both the efficacy and safety of drugs as important factors when self-medicating.

Perceptions of West Virginia Teens and Adults Regarding the Risks of Over-the-Counter Pain Medications

More than 1 billion people live with chronic pain, including 100 million Americans, with a majority utilizing prescription and over-the-counter (OTC) pain medications. OTC medications are readily available and facilitate generally positive efficacy, yet misuse leads to a high number of medication-related problems, with acetaminophen alone accounting for more than 50,000 emergency department visits annually. The West Virginia Health Sciences and Technology Academy (HSTA) high school student program and the West Virginia University Health Sciences Center collaborated to accomplish 2 objectives: to assess and compare knowledge and perceptions of OTC pain medications in the West Virginia community and to develop and provide educational interventions to high school students regarding knowledge and perceptions of OTC pain medications. Resulting student knowledge data illustrated a statistically significant improvement in knowledge. Community survey screening data resulted in 85% answering two-thirds of the knowledge questions incorrectly, with 12% (140 of 1174 participants) answering every single knowledge survey question incorrectly. These data strongly exhibit not only the incredible need for OTC pain medication community education but also that this study's educational methods were very effective at teaching high school students, with possible applicability to the entirety of society.

Over-The-Counter Analgesics: A Meta-Synthesis of Pain Self-Management in Adolescents

BACKGROUND

The consumption prevalence of OTC medication ranges between 57% and 78% among adolescents in the United States of America; however, the reasons for self-medication with OTC analgesics have not been systematically examined.

AIMS

The purpose of this meta-synthesis is to generate new knowledge and theoretical understanding of adolescents' use of over-the-counter (OTC) analgesics.

DESIGN

Qualitative meta-ethnography using Noblit and Hare's (1988) approach.

SETTINGS

PARTICIPANTS/SUBJECTS: METHODS: We identified qualitative studies in the CINAHL, PubMed, PsycINFO, and ProQuest Dissertation and Thesis databases that addressed OTC analgesic use in adolescents, were published between 2006 and 2018, and were written in English. Themes were extracted from studies meeting inclusion/exclusion criteria and a meta-ethnographic analysis was conducted.

RESULTS

Seven studies met inclusion/exclusion criteria. Four themes were identified that described reasons for adolescent use of OTC analgesics for pain management: 1) survival instinct; 2) placebo for stress and anxiety control; 3) accessibility; and 4) consumer socialization.

CONCLUSIONS

Findings suggest that OTC analgesic use is common among adolescents to treat pain and other non-medically-indicated conditions, such as stress and anxiety.

Medication Education Provided to School-Aged Children: A Systematic Scoping Review

OBJECTIVES

To characterize the educational interventions regarding prescription and nonprescription medication use for school-aged children, we systematically reviewed evidence of programs available for this age group.

METHODS

Searches in PubMed, CINAHL, EMBASE, ERIC, and International Pharmaceutical Abstracts were conducted. Search terms focused on: population education, school-age children, and medications. Studies were excluded if they were specific to a particular disease state or class of medication, drugs of misuse and illicit drugs. Data extraction included study design, location, educational intervention and duration, research methods, and main findings.

RESULTS

We found 14 studies representing 8 separate projects. Six projects were identified in the gray literature. Projects ranged from individual sessions to national programs. Quantitative studies showed improvement in knowledge, medication literacy, and confidence. The adoption of medication education strategies was dependent on the educator's comfort level and beliefs regarding medication safety.

CONCLUSIONS

Credible medication education resources are available and have been shown to improve students' knowledge. There remains a need for multifaceted implementation and evaluation strategies. Strategies and resources are available to implement interventions in communities to address medication education in school-age children. Frameworks should be used to facilitate the implementation of effective health promotion strategies around safe-medication use for school-aged children.

The perceived benefits of student pharmacists educating children about over-the-counter medication safety

BACKGROUND AND PURPOSE

To characterize the perceived impact of a student pharmacist-led over-the-counter (OTC) medication safety program for children.

EDUCATIONAL ACTIVITY AND SETTING

An OTC medication safety program was implemented by student pharmacists at a western Pennsylvania pharmacy school by educating fifth and sixth graders for three years. An online survey and follow-up interviews were conducted to examine the program's perceived effectiveness and usefulness.

FINDINGS

23% of program participants completed the survey and 18 follow-up interviews were conducted. Most participants were female, white, and student pharmacists. Respondents were satisfied with the program and perceived that it was useful (97%) and effective (94%) in teaching children OTC medication safety. Most participants (97%) reported that OTC medication safety is an important issue that children should learn about, expressed interest in participating in the program again, and recommended expanding the program. Children learned appropriate medication use, the Poison Control Center as a resource, and pharmacists' role in medication safety. Student pharmacists developed pediatric communication and community engagement skills, while learning about children's medication knowledge and interests. Program improvements included educating parents, expanding the program, and incorporating the use of technology.

SUMMARY

The student pharmacist-led program was perceived to be effective in communicating with fifth and sixth grade children about OTC medication safety. The program provided experiential opportunities for student pharmacists to practice counseling skills with children regarding safe and appropriate use of medicines.

Adolescents' Misuse of Over-The-Counter Medications: The Need for Pharmacist-led Intervention

Adolescents' misuse of over-the-counter (OTC) medications is a growing patient safety concern, resulting in an alarming number of poisonings and emergency department visits. OTC medications are easily accessible and adolescents often have the misconception that these medications are safe, even at higher than recommended doses. Dextromethorphan and acetaminophen are the most common and frequently misused OTC medications among adolescents, with significantly dangerous health risks if used improperly. Pharmacists are critical to the provision of education on safe OTC medication use for adolescents and their family caregivers by leading and implementing relevant community-based interventions. Ideal channels in which to do this in the community are pharmacies and schools. It is challenging to gain the attention of adolescents and to engage them; methods that include innovative measures and initiatives may be the solution. Research is needed to determine how pharmacists can improve adolescents' knowledge and safe use of OTC medications. Pharmacists must be supported through training and acquisition of expertise specific to adolescent engagement and education. The development of pharmacist-led educational interventions that are tailored for adolescents that address their limited OTC medication knowledge and raise awareness of safety risks associated with misuse is crucial to preventing and reducing this patient safety problem in the community.

Evaluation of Over-the-Counter Medication Knowledge and Literacy in Adolescent Students

OBJECTIVE

To 1) assess and compare knowledge and literacy of over-the-counter (OTC) medications among middle school (MS) and high school (HS) students, and 2) to assess student self-identified lack of knowledge regarding OTC medications.

METHODS

A convenience sample of suburban adolescent students completed a 2-part survey about OTC medications: part 1 included demographics and baseline knowledge of OTCs, and part 2 included medication label interpretation (literacy). Descriptive statistics and chi-square test were used to summarize and compare responses among MS and HS students.

RESULTS

Students (n = 309) were in MS (46.2%) and HS (53.8%), with a mean age of 14 ± 1.8 years, 61.4% male, 81.2% white, and 84.3% non-Hispanic. A majority of students (68.5%) agreed that they always speak with an adult before taking medication. Students responded correctly to 19% of brand versus generic knowledge questions; conversely, 65% selected "I don't know." Similar trends were seen for questions about medication indications (26% correct, 59% didn't know), side-effects (8% correct, 67% didn't know), and combining medications (21% correct, 63% didn't know). When students referenced a medication label, 55% answered label interpretation questions correctly and 30% reported "I don't know." HS students answered more questions correctly and were less likely to report "I don't know" to questions about common OTC medications (eg, ibuprofen, Tylenol, etc) compared with MS students (P < .05).

DISCUSSION

Overall, baseline knowledge of OTC medications was low; however, students were better at interpretation of drug labels. MS students self-reported less knowledge about common OTC medications compared with HS students. This study provides an important foundation for future OTC medication educational programs for adolescents.

A systematic review of self-medication practices among adolescents

The purpose was to systematically review the global trends and factors influencing self-medication (SM) among adolescents. Databases (Medline/Pubmed, Ingenta, Cochrane Library, EMBASE, CINAHL, Proquest, Scopus, and Google Scholar) were searched for peer-reviewed research published between January 2000 and December 2013 on SM among adolescents aged 13-18 years. Articles were scrutinized for country of origin, sample size, recall period, prevalence rates and associations, influencing factors, medicines used, self-medicated health complaints, sources of drug information, recommendation and procurement, knowledge about medicines, and adverse drug reactions. One hundred and sixty-three publications met the inclusion criteria. SM prevalence ranged from 2% to 92% in different countries. The most frequently self-medicated over-the-counter and prescription-only medicines were analgesics and antibiotics, respectively. Headache, allergies, and fever were the most common self-medicated health complaints reported. Misuse of both over-the-counter and prescription-only medicines reflected a risky trend. Female gender, older age, maternal education, and familial practices were associated with SM among adolescents. The primary sources of drug information, recommendation, and procurement included pharmacists, parents, and friends. High-risk practices such as diversion of prescription medicines and utilization of previous prescriptions were also reported. Most studies revealed gaps in drug knowledge, although adolescents self-rated it as satisfactory. However, few adverse drug reactions were reported, probably because of lack of awareness about the potential harmful effects of medicines. Recommendations for "responsible SM" have been made to minimize the adverse effects of SM. Understanding the links between various factors promoting SM can be helpful in deriving strategies aimed at reducing drug-related health risks among adolescents. Moreover, these will aid in creating awareness among adolescents about the potential risks of using drugs without proper information and consultation. Studies need to be designed to assess the changing trend and identify new correlates of self-medication practices among adolescents, which pose fresh challenges to monitor the menace.