Television and Adolescent Use of Over-the-Counter Analgesic Agents

Factors Influencing Medicine Use Behavior in Adolescents in Japan Using a Bayesian Network Analysis

Background: Medicine education in Japan was introduced to junior high schools in 2012. However, the effectiveness of existing education programs is limited. In order to develop more effective programs for high school students, the present study investigated the variables that directly influence medicine use behavior and the magnitude of their influence, using a Bayesian network analysis. Methods: A national cross-sectional survey was conducted in 2017. Eighty-three public high schools across Japan were randomly selected, and questionnaires were administered to 15-16 years old 10th grade students. The number of valid responses was 17,437 (effective response rate was 98.46%). Responses were analyzed to measure students' behavior toward, attitudes regarding, and knowledge of medicines, and awareness of their prior medicine education. Results: Students' "attitude score" and "awareness of a class" directly influenced their "behavior score." The "score on attitude," which had a large influence on "score on behavior," was directly influenced by "score on knowledge of proper use" and "awareness of class." Conclusion: The present study argues that acquiring knowledge of appropriate medicine use leads to the acquisition of favorable attitudes, which may result in behavioral change. Therefore, for medicine education, it is expected that incorporating content related to knowledge acquisition for changing attitudes will be important for promoting behavioral change.

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.

Analgesics and anti-inflammatory medications in sports: use and abuse

Both acute and overuse musculoskeletal injuries are common in adolescent athletes. Pharmacologic agents including nonsteroidal anti-inflammatory drugs, acetaminophen, and topical over-the-counter agents have been shown to be effective in controlling pain, but data regarding their efficacy in expediting healing and time to recovery continue to be debated. Studies indicate that adolescents consume analgesic agents on their own and may be unaware of their potential toxicities. Data also indicate that adolescent athletes use medications in hopes of alleviating pain and allowing continuation of sports without adequate time for healing. This article reviews the mechanisms, toxicity, drug interactions, efficacy, and abuse potential of commonly used analgesic and anti-inflammatory drugs.

A cross-media analysis of educational information content of advertisements for over-the-counter medicines in a Nigerian urban setting

Objective

To analyse the educational information content of adverts for over-the-counter (OTC) medicines on radio, television and billboards in a Nigerian urban setting.

Method

A cross-sectional coding of educational information content of adverts for OTC medicines broadcast on radio and television and shown on billboards in a Nigerian urban setting within a 3-month study period. Two coders independently assessed 1492 adverts comprising 49 brands for information on targeted medical conditions and OTC medicines advertised as treatment.

Results

Inter-rater reliability among the two coders, determined with Cohen’s Kappa, was 0.81 (95% confidence interval, 0.77–0.90). Analgesics, multi-vitamins/hematinics and anti-malarial drugs were the most frequently advertised OTC drug classes on all media. Symptoms and underlying cause/risk factors of targeted medical conditions were contained in a minority of adverts. The majority (81.5–100%) of the adverts projected the name of the medical condition for which the OTC medicines were advertised, whereas the symptoms and underlying cause/risk factors of these medical conditions were contained in only a minority of adverts. Name and identification features were the most frequently projected educational information (100%) pertaining to OTC medicines in advertised treatments. Information on the time to onset of action was contained in 40–80% of adverts, but this information was provided with the use of qualitative words such as fast and rapid. Information on dose, frequency, duration, side effects and precautions were provided in a minority of adverts in all media. Adverts for OTC medicines on television had the highest combined educational information scores of 5.0, followed by billboards (4.1) and radio (3.0). The combined educational information scores of adverts for OTC medicines on the three media fell short of the maximum obtainable score of 11. Adverts for anti-malarial drugs (100%) and OTC analgesics projected inaccurate information with regards to the efficacy of the advertised medicines.

Conclusion

The majority of adverts for OTC medicines on radio, television and billboards in a Nigerian urban setting contained insufficient educational information to guide informed drug purchase and rational use of medicines during self-medication. Promotional efforts appeared focused on high consumer awareness of the targeted medical conditions and the name/identification of the OTC medicines advertised as treatments. This may further worsen the well-documented irrational use of medicines in Nigeria.

[Self-medication with over-the-counter analgesics among 15-16 year-old teenagers]

BACKGROUND

OTC analgesics were released for sale outside pharmacies in Norway in 2003. This study assesses indications and frequency of use of these drugs among 15-16 year-old teenagers in Norway after 2003.

MATERIAL AND METHOD

We developed a questionnaire, which contained 65 questions with one or more response options. This was given to all pupils in the final grade at six junior high schools in a town with 60,000 inhabitants (Drammen).

RESULTS

367 of 626 (58.6 %) pupils participated. 50 % of the boys and 71 % of the girls had used OTC analgesics during the last four weeks; 26 % of them on a daily or weekly basis. Girls experienced episodes of pain more frequently than boys, but the proportion of episodes treated with analgesics did not differ between the sexes. Headache and muscle pain were common. Half of those with severe headache/migraine used OTC analgesics on a daily or weekly basis. The teenagers reported several reasons for experiencing pain and discomfort, such as long time spent in front of various screens, tight time schedules with physical exercise and friends, drinking too little and much noise in the classroom.

INTERPRETATION

Use of OTC analgesics has increased considerably among Norwegian teenagers. Drug-induced headache may occur as an adverse event. If more effort is made to improve life situations that adolescents perceive as painful and a cause of discomfort, the need for OTC analgesics may be reduced.

Knowledge and sources of information about medicines among adolescents in Malta

Objective

To investigate knowledge of medicines and sources of information about medicines among adolescents in Malta.

Methods

A self-administered questionnaire was used to survey knowledge of medicines and information sources among adolescents attending secondary schools in Malta. A random stratified sample design generated a sample size of 514 students. Knowledge of medicines was investigated by questions that included topics about the efficacy of medicines, proper communication during a medical consultation, the safety of medicines, antibiotic use and pictograms.

Results

The analytical sample, of which 53.8% were girls, was made up of 474 students, aged 1416 years. The students obtained a mean score of 22.92 points (SD = 4.31) out of a maximum of 32 points for medicine knowledge. More than 30.0% of the respondents did not mark the correct answer for 40.6% of the questions that investigated knowledge of medicines. The family physician, community pharmacist and parents were the sources of information that were mostly cited. A proportion of 4.4% had obtained information from the teacher. A quarter of the respondents (24.7%) had obtained information from friends/schoolmates, young relatives or the media, generally television (17.3%).

Conclusion

Although the level of knowledge about medicines among this study sample of Maltese students was good, there appeared to be particular misconceptions with regard to important aspects associated with the proper use of medicines. These findings highlight the need to educate adolescents about the proper use of medicines. The most important information providers about medicines appeared to be the physician, pharmacist and parents. It is being suggested that education campaigns should be organized in order to help parents guide adolescents on how to use medicines appropriately. In addition, adolescents would benefit if more information about the proper use of medicines would be disseminated by means of television programs and school-based health education curricula.

Adolescents in clinical trials

Drug development is a lengthy, costly, and complex process, with clinical trials essential for characterizing dosing, safety, and efficacy in treated populations. After regulatory approval, aggressive marketing ensures that most drugs are used by a broad spectrum of ages, genders, races, and ethnic groups. Unfortunately, not all groups are adequately represented in clinical trials; adolescents are commonly overlooked. This commentary explores how adolescents are considered during drug development, with a special focus on the influence of inherent psychosocial, biological, ethical, and regulatory issues in their recruitment and participation in clinical studies leading to drug licensing.