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Ishii K, Okita K. Potential effect of ketamine in treatment for dextromethorphan use disorder exploding in Japanese young population. Asian J Psychiatr 2024; 99:104164. [PMID: 39047355 DOI: 10.1016/j.ajp.2024.104164] [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: 06/30/2024] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 07/27/2024]
Abstract
In Japan, the landscape of clinical practice for substance use disorder is changing significantly, primarily due to an increase in patients using over-the-counter drugs. A major concern is the rising number of patients misusing dextromethorphan (DXM). These patients with DXM use disorders often have severe trauma-related and mood symptoms, and therefore try to cope with those symptoms by self-medicating with DXM. In this article, we propose that ketamine, which has similar psychopharmacological effects to DXM, may be a useful alternative pharmacological treatment for these patients.
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Affiliation(s)
- Kaori Ishii
- Department of Pharmacology, Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Laboratory of Pharmacotherapeutics, Faculty of Pharmaceutical Science, Tokyo University of Science, Tokyo, Japan
| | - Kyoji Okita
- Department of Psychiatry, Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan.
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2
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Sommerfeld-Klatta K, Jiers W, Rzepczyk S, Nowicki F, Łukasik-Głębocka M, Świderski P, Zielińska-Psuja B, Żaba Z, Żaba C. The Effect of Neuropsychiatric Drugs on the Oxidation-Reduction Balance in Therapy. Int J Mol Sci 2024; 25:7304. [PMID: 39000411 PMCID: PMC11242277 DOI: 10.3390/ijms25137304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/30/2024] [Accepted: 07/01/2024] [Indexed: 07/16/2024] Open
Abstract
The effectiveness of available neuropsychiatric drugs in the era of an increasing number of patients is not sufficient, and the complexity of neuropsychiatric disease entities that are difficult to diagnose and therapeutically is increasing. Also, discoveries about the pathophysiology of neuropsychiatric diseases are promising, including those initiating a new round of innovations in the role of oxidative stress in the etiology of neuropsychiatric diseases. Oxidative stress is highly related to mental disorders, in the treatment of which the most frequently used are first- and second-generation antipsychotics, mood stabilizers, and antidepressants. Literature reports on the effect of neuropsychiatric drugs on oxidative stress are divergent. They are starting with those proving their protective effect and ending with those confirming disturbances in the oxidation-reduction balance. The presented publication reviews the state of knowledge on the role of oxidative stress in the most frequently used therapies for neuropsychiatric diseases using first- and second-generation antipsychotic drugs, i.e., haloperidol, clozapine, risperidone, olanzapine, quetiapine, or aripiprazole, mood stabilizers: lithium, carbamazepine, valproic acid, oxcarbazepine, and antidepressants: citalopram, sertraline, and venlafaxine, along with a brief pharmacological characteristic, preclinical and clinical studies effects.
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Affiliation(s)
- Karina Sommerfeld-Klatta
- Department of Toxicology, Poznań University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
| | - Wiktoria Jiers
- Department of Toxicology, Poznań University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
| | - Szymon Rzepczyk
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznań, Poland
| | - Filip Nowicki
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznań, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznań University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznań, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznań, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznań University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
| | - Zbigniew Żaba
- Department of Emergency Medicine, Poznań University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznań, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznań, Poland
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Plewa S, Pietkiewicz D, Kokot ZJ, Matysiak J. A Review of Wastewater-Based Epidemiology Studies for the Assessment of Over-the-Counter Medicines Used as Recreational Drugs: The Example of Dextromethorphan. Med Sci Monit 2024; 30:e944120. [PMID: 38902914 PMCID: PMC11305112 DOI: 10.12659/msm.944120] [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: 02/13/2024] [Accepted: 04/02/2024] [Indexed: 06/22/2024] Open
Abstract
The 'recreational use' of selected over-the-counter (OTC) medicines is an unofficial activity. The traditional surveys assessing the use of drugs are affected by the bias of underreporting and are thus unreliable. The development of analytical techniques helps to monitor the substances at trace levels, such as in wastewater, and might be applied to estimate the consumption of an analyte of interest and ensure additional, evidence-based information complementary to population surveys. We reviewed studies focused on evaluating the estimated consumption of drugs as a reliable and unbiased source of evidence-based information (called wastewater-based epidemiology, WBE) to monitor the scale of this phenomenon. We found there is a need to test not only narcotics in the environment but also medicines that may be abused or recreationally used. The reviewed studies show methods that might provide reliable information about consumption of drugs, narcotics, and OTC medications for proposing targeted, preventive actions. Moreover, as all the selected studies were based on mass spectrometry, there is a potential to include the dextromethorphan and/or related compounds as part of the screening for narcotics and OTC drugs that can be socially harmful, overused, or misused. This article reviews the analytical methods for detecting dextromethorphan and/or its transformation products in environmental water samples.
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Affiliation(s)
- Szymon Plewa
- Department of Inorganic and Analytical Chemistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Dagmara Pietkiewicz
- Department of Inorganic and Analytical Chemistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Zenon J. Kokot
- Faculty of Health Sciences, Calisia University, Kalisz, Poland
| | - Jan Matysiak
- Department of Inorganic and Analytical Chemistry, Poznań University of Medical Sciences, Poznań, Poland
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Usami T, Okita K, Shimane T, Matsumoto T. Comparison of patients with benzodiazepine receptor agonist-related psychiatric disorders and over-the-counter drug-related psychiatric disorders before and after the COVID-19 pandemic: Changes in psychosocial characteristics and types of abused drugs. Neuropsychopharmacol Rep 2024; 44:437-446. [PMID: 38622878 PMCID: PMC11144616 DOI: 10.1002/npr2.12440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/17/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
AIM To investigate changes in the clinical characteristics of patients who abused benzodiazepine receptor agonists (BZRA) or over-the-counter (OTC) drugs before and after COVID-19 based on the 2018 and 2022 data of the "Nationwide Psychiatric Hospital (NPH) Survey on Drug-related Psychiatric Disorders." METHOD A total of 446 and 155 cases, and 435 and 273 cases, who mainly abused BZRAs or OTC drugs, respectively, were extracted from the database of the two NPH Surveys. Demographic variables, education, employment, criminal record, drug use during the previous year, psychiatric diagnosis, and types of abused drugs were compared between 2018 and 2022. RESULT A comparison of BZRA abusers revealed a decreased number of users during the previous year and an increase in the comorbidity rate of other disorders (F3 and F4 in ICD-10) in 2022. Etizolam, flunitrazepam, triazolam, and zolpidem were used most in both years, with an increase in zolpidem and a decrease in triazolam in 2022. A comparison of OTC drug abusers revealed a higher proportion of women and young patients in 2022. An increase in the comorbidity rate of F3 and F9 and a significant increase in the use of dextromethorphan products were observed in 2022, although codeine products were in the majority in both years. CONCLUSION By comparing NPH Surveys before and after the COVID-19 pandemic, both BZRA abusers and OTC drug abusers present complex pathologies, requiring tailor-made treatment. The younger OTC drug abusers were particularly evident among women, and the abuse of dextromethorphan-containing OTC drugs has increased alarmingly.
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Affiliation(s)
- Takashi Usami
- Kitakyushu Municipal Mental Health Welfare CenterKitakyushuFukuokaJapan
- Department of Drug Dependence ResearchNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Kyoji Okita
- Department of Drug Dependence ResearchNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Takuya Shimane
- Department of Drug Dependence ResearchNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Toshihiko Matsumoto
- Department of Drug Dependence ResearchNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaTokyoJapan
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ALzayadneh EM, ALHadidi KA, Alasasfeh I, Battah A, Khasawneh SM, Faouri MN, Diab RW, Alzagareet YM, Abbas NH, Al-Debei RH, Zaqqa AM, Hadidi FK, Khraisat LM. General pattern of paediatric poisoning in Jordan during 2018-2019. Toxicol Rep 2024; 12:369-374. [PMID: 38572466 PMCID: PMC10987798 DOI: 10.1016/j.toxrep.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Acute accidental poisoning in children remains a significant public health issue and a predictable cause of morbidity around the world. To take preventive measures, it is necessary to identify the pattern of this problem. Objective To determine the extent and characteristics of paediatric poisoning, an epidemiological investigation specific to each country is required. The goal of our research was to determine the current pattern of acute poisoning in children between (0-5) years old in Jordan. Methods This retrospective study performs a descriptive analysis of the Jordan University Hospital's National Poison Information Center (NPIC) database and describes the epidemiology of acute poisoning in children between (0-5) years old during a period of two years (2018-2019). Results Paediatric poisoning (0-5) years old accounts for approximately 88% of poisoning cases in Jordan between 2018 and 2019.Out of 3531 paediatric poisoning cases, 44.9% of cases were in children between (2-3) years old, 63.4% of subjects were male. 40.9% of calls were from governmental hospitals. Most cases occurred at home (98.7%) and were unintentional (98.6%). Medication poisoning was the commonest among cases (71.0%). Besides, 89.4% were asymptomatic at the time of call, and Central Nervous System (CNS) symptoms being the most common (3.6%) among the symptomatic cases. Conclusions Most cases of paediatric poisoning handled by the NPIC was due to medications. To prevent or minimize these cases, it is necessary to educate parents and other caregivers about proper medication storage and use, and in case of poisoning, urgent referral to health facilities is required.
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Affiliation(s)
- Enas M. ALzayadneh
- Department of Paediatric, School of Medicine, the University of Jordan, Jordan
| | - Kamal A. ALHadidi
- Department of Pathology Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Jordan
- Jordan Poison Information Center- Jordan University Hospital, Jordan
| | - Ihab Alasasfeh
- Department of Emergency-Jordan University Hospital, General Surgery Department, School of Medicine, the University of Jordan, Jordan
| | - Abdelkader Battah
- Department of Pathology Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Jordan
| | | | - Madeha N. Faouri
- Department of Pharmacy, School of Nursing, Al-Balqa’ Applied University, Jordan
| | | | | | | | | | - Ayah M. Zaqqa
- School of Medicine, the University of Jordan, Jordan
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Tanibuchi Y, Omiya S, Usami T, Matsumoto T. Clinical characteristics of over-the-counter (OTC) drug abusers in psychiatric practice in Japan: Comparison of single and multiple OTC product abusers. Neuropsychopharmacol Rep 2024; 44:176-186. [PMID: 38299253 PMCID: PMC10932778 DOI: 10.1002/npr2.12415] [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: 10/02/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE To examine the clinical characteristics of over-the-counter (OTC) drug abusers in psychiatric practice in Japan. METHOD We examined the attributes, ICD-10 subcategory, and comorbid mental disorders of patients who mainly abuse OTC products and compared the clinical characteristics of single product and multiple products abusers, using the database of the "2022 Nationwide Mental Hospital Survey of Drug-related Disorders." RESULTS Among the 2468 subjects included in this survey, 273 (11.1%) used OTC products as main drugs. Of these, 209 (78.3%) and 58 (21.7%) were classified into the single product group and the multiple products group, respectively. Six were excluded for unknown ingredients. By comparing these groups, we found that many of the multiple products group consisted of young women who were recently treated for drug problems. Many subjects in the group also had a short treatment period. No differences were observed between the groups regarding the ICD-10 F1 subcategory, but many subjects in the multiple products group fulfilled the criteria of F6 "disorders of adult personality and behavior." CONCLUSION OTC products are easily accessible drugs of abuse for young women in Japan. The results of this study indicate the necessity to reconsider the educational approach for preventing drug abuse, which has focused on illicit drugs. The study also indicates that some OTC products, which contain ingredients banned overseas due to their harmful effects, are still sold in Japan and that abusers for those products exist. Measures by the government are considered urgently needed.
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Affiliation(s)
- Yuko Tanibuchi
- Chiba HospitalFunabashiJapan
- Department of Drug Dependence Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaJapan
| | - Soichiro Omiya
- Department of Drug Dependence Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaJapan
- Clinical Psychology, Graduate School of EducationJoetsu University of EducationJoetsuJapan
| | - Takashi Usami
- Department of Drug Dependence Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaJapan
- Kitakyushu Municipal Mental Health Welfare CenterKitakyushuJapan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaJapan
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Oinas JP, Wazaify M, Laaksonen R. Preventing the Abuse and Misuse of Over-the-Counter Medicines: A Survey of Community Pharmacists in Finland. Subst Use Misuse 2024; 59:411-420. [PMID: 37941407 DOI: 10.1080/10826084.2023.2275564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Over-the-counter (OTC) medicines intended for short-term use for self-care may be abused or misused. AIM To explore the experiences and perceptions of community pharmacists (dispensers, pharmacists, and pharmacy owners) of the use, abuse, and misuse of OTC medicines by pharmacy customers, and to identify their perceptions of the most appropriate methods to prevent inappropriate use of OTC medicines. METHOD A cross-sectional national online survey to community pharmacists in Finland. A previously validated structured questionnaire was modified. Three national pharmaceutical associations were contacted to help in recruitment of their members (n = 5594, calculated target sample size n = 360). Descriptive statistical analyses were conducted. RESULTS In total, 442 responses were received. Most respondents strongly agreed (Md all = 5) that OTC medicines could be abused or misused; pharmacy owners were more likely to strongly agree than pharmacists (p = 0.012). Pharmacy owners were more likely to think that laxatives were liable for abuse than dispensers (p = 0.008), and that travel sickness medicines were liable for misuse than dispensers (p < 0.001) and pharmacists (p = 0.013). Patient counseling was the most commonly employed method to prevent the problem. Respondents perceived that providing training to staff about OTC medicines that can be abused (Md all = 5) was the most appropriate strategy to prevent OTC medicine abuse; pharmacy owners were more likely to strongly agree or agree of this (p = 0.005) than dispensers. Conclusion: Community pharmacists are aware of the liability of OTC medicines for the potential abuse and misuse. They employ various methods as advising and counseling the customer to support the rational use of OTC medicines.
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Affiliation(s)
- Juha-Pekka Oinas
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Raisa Laaksonen
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland
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Malli IA, Hubayni RA, Marie AM, Alzahrani DY, Khshwry EI, Aldahhas RA, Khan RF, Zaidi SF. The prevalence of self-medication and its associated factors among college students: Cross-sectional study from Saudi Arabia. Prev Med Rep 2023; 36:102457. [PMID: 37869536 PMCID: PMC10589874 DOI: 10.1016/j.pmedr.2023.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023] Open
Abstract
Background Self-medication with OTC or prescription drugs is widespread, may impair health, and leads to microbial resistance. Self-medication treats symptoms without a prescription. Self-medication is common among students across disciplines. Thus, this study evaluates medical and non-medical students' self-medication prevalence, knowledge, and variables. Methods 352 people completed a verified 25-item online questionnaire from September 5 to November 17, 2021. Self-medication and demographic characteristics such as gender, professional college, and family income were examined using a chi-square test of independence. Results 210 (59.6 %) participants were from the College of Medicine, and 142 (40.34 %) were from other professional health colleges. Health professional students self-medicated 55.9 %. This research found substantial connections between self-medication knowledge, gender, and family income. With a p-value of 0.0001, 32 % of women agreed that self-medication is safe, compared to 15.8 % of men. Female students were more likely than boys (61.9 % vs 38.1 %, p-value = 0.0291) to self-medicate as their initial therapy. Family income was also related to self-medication; 69.6 % of low-income pupils self-medicated to reduce doctor visits, p-value = 0.0477. Conclusion Students of all majors self-medicate. Medical students were more informed about generic drug safety and administration. There were substantial unfavorable sentiments regarding self-medication, highlighting the need for educational health activities to raise student understanding of its risks.
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Affiliation(s)
- Israa Abdullah Malli
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Rahaf Ahmed Hubayni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Amirah Mohammed Marie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Dhaii Yahya Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Elaf Ismeal Khshwry
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Raghad Abdulmohsen Aldahhas
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Rahaf Fayez Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia
| | - Syed Faisal Zaidi
- Faculty of Eastern Medicine, Hamdard University, Islamabad Capital Territory, Pakistan
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Gianesini S, De Luca L, Feodor T, Taha W, Bozkurt K, Lurie F. Cardiovascular Insights for the Appropriate Management of Chronic Venous Disease: A Narrative Review of Implications for the Use of Venoactive Drugs. Adv Ther 2023; 40:5137-5154. [PMID: 37768506 PMCID: PMC10611621 DOI: 10.1007/s12325-023-02657-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023]
Abstract
Evidence suggests that chronic venous disease (CVD) may be a cardiovascular disorder, as patients with CVD are prone to developing arterial (atherosclerosis) and venous (thromboembolism) diseases. This may be partly explained by shared risk factors. Thus, patients with CVD or cardiovascular disease require careful history-taking and physical assessment to identify coexisting pathologies and risk factors. This article summarises a symposium at the XIX World Congress of the International Union of Phlebology held in Istanbul, Turkey, in September 2022. Common pathophysiological features of CVD and cardiovascular disease are endothelial injury, hypercoagulability and systemic inflammation. In CVD, inflammation primarily affects the microcirculation, with changes in capillary permeability, vein wall and valve remodelling and increase in oxidative stress. Once patients develop symptoms/signs of CVD, they tend to reduce their physical activity, which may contribute to increased risk of cardiovascular disease. Data show that the presence of CVD is associated with an increased risk of cardiovascular disease, including peripheral arterial disease and heart failure (HF), and the risk of adverse cardiovascular events increases with CVD severity. In addition, patients with cardiovascular disease, particularly those with HF, are at increased risk of venous thromboembolism (VTE) and should be assessed for VTE risk if they are hospitalised with cardiovascular disease. Therefore, CVD management must include a multi-specialty approach to assess risk factors associated with both the venous and arterial systems. Ideally, treatment should focus on the resolution of endothelial inflammation to control both CVD and cardiovascular disease. International guidelines recommend various conservative treatments, including venoactive drugs (VADs), to improve the symptoms/signs of CVD. Micronized purified flavonoid fraction (MPFF) is a VAD, with high-quality evidence supporting its use in relieving symptoms/signs of CVD and improving quality of life. Moreover, in large-scale observational studies, MPFF has shown superior effectiveness in real-world populations compared with other VADs. Video Abstract. (MP4 97173 kb).
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Affiliation(s)
- Sergio Gianesini
- Translational Medicine Department, University of Ferrara, Via Porta a Mare 11, 45100, Ferrara, Rovigo, Italy.
| | - Leonardo De Luca
- Division of Cardiology, Department of Cardio-Thoracic and Vascular Medicine and Surgery, A.O. San Camillo-Forlanini, Rome, Italy
| | - Toni Feodor
- Medical Center for Diagnosis, Ambulatory Treatment and Medical Prevention, Surgery Clinic 'Sf. Nicolae', Bucharest, Romania
| | - Wassila Taha
- Non-Invasive Vascular Laboratory, AlSalam Hospital Mohandessin, Cairo, Egypt
| | - Kursat Bozkurt
- Department of Cardiovascular Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Fedor Lurie
- Jobst Vascular Institute, Toledo, OH, USA
- Division of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
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Amador-Fernández N, Escaith M, Simi E, Quintana-Bárcena P, Berger J. Evaluation of an enhanced service for medication review with follow up in Swiss community pharmacies: Pre-post study protocol. PLoS One 2023; 18:e0292037. [PMID: 37847695 PMCID: PMC10581489 DOI: 10.1371/journal.pone.0292037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/09/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND In Switzerland, 20,000 people are hospitalized each year as result of drug related problems (DRPs). The sources of DRPs can be related to patients' behavior (i.e., wrong administration) or to health processes (i.e., drug-drug interaction). No community pharmacy (CP) service focus on DRPs related to patients' behavior is currently recognized or remunerated in Switzerland. A medication review with follow up (MRF) has been developed to evaluate prescription and non-prescription medication. OBJECTIVE To evaluate the impact of MRF service for the identification and management DRPs associated to patients' behavior and to describe pharmaceutical interventions carried out through MRF. METHODS A pre-post intervention study with a cluster design and one intervention group will be carried out in CPs in the canton of Vaud (Switzerland) for 15 months. Volunteer pharmacists will be trained on the identification and management of DRPs related to patients' behavior. After training, they will include randomly selected adults taking four or more chronic drugs prescribed for at least three months prior to recruitment. Then, they will conduct three pharmacist-patient face-to-face consultations at 6-month intervals. Tasks will be differentiated by pharmacy technician or pharmacist to triage expired medication or to manage DRPs in a structured manner, respectively. The primary outcome is the identification of DRPs associated to patients' behavior. Secondary outcomes are to assess patients' medication knowledge, number of expired medications, interventions carried out by pharmacists and pharmacists' satisfaction. The study will begin in April 2023 in 19 to 35 pharmacies that will recruit at least 162 patients. A sub analysis will be carried out for patients with 65 years old or over. CONCLUSIONS The MRF intervention features a training designed for an enhanced evaluation of patient's behavior towards their medication. The study will allow the assessment and management of DRPs in Swiss CPs with the support of the local health authorities and pharmacist association. TRIAL REGISTRATION Clinicaltrials.gov NCT05348538.
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Affiliation(s)
- Noelia Amador-Fernández
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Mathilde Escaith
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Elodie Simi
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Patricia Quintana-Bárcena
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Jérôme Berger
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
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11
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Al Meslamani AZ, Abdel-Qader DH. The Abuse and Misuse of Over-the-Counter Medicines During COVID-19. Hosp Pharm 2023; 58:437-440. [PMID: 37711408 PMCID: PMC9988622 DOI: 10.1177/00185787231158777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The abuse and misuse of OTC medicines is a common problem in community pharmacies and is expected to escalate during the COVID-19 pandemic. However, there is limited research on the patterns, causes, and consequences of these incidents during the pandemic. This article aims to provide evidence-based insights into the potential impact of COVID-19 on the abuse and misuse of OTC medicines, and suggest strategies for reducing these occurrences for pharmacy practitioners and healthcare managers.
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12
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Tobaiqy M, AlZahrani FA, Hassan AS, Alirbidi AH, Alraddadi OA, AlSadah OA, Yamani MB, Alqutub ST. Community Pharmacists' Knowledge, Attitudes and the Perceived Safety and Effectiveness of Melatonin Supplements: A Cross-Sectional Survey. PHARMACY 2023; 11:147. [PMID: 37736919 PMCID: PMC10514787 DOI: 10.3390/pharmacy11050147] [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: 08/15/2023] [Revised: 09/02/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
Melatonin, which is classified as a dietary supplement by the Saudi Food and Drug Authority, is used to manage sleep disorders. In this study, community pharmacists' knowledge and attitudes about dispensing melatonin supplements and the perceived safety and effectiveness of melatonin were assessed. A cross-sectional survey of community pharmacists in Jeddah, Saudi Arabia was conducted from March-June 2023. Community pharmacists' knowledge and attitudes towards prescribing and dispensing melatonin supplements, the methods of dispensing melatonin supplements (prescription, over the counter, self-administered), indications, ages of users, dosage forms, and adverse drug reactions related to melatonin use among consumers were surveyed using a questionnaire. Potential participants were approached face to face, a questionnaire was administered to those agreeing to participate in the study, and responses were recorded electronically. The response rate of the 300 community pharmacists who participated in this study was 83.5%. The mean age of participants was 33.6 years, and 89.3% (n = 268) of community pharmacists reported dispensing melatonin supplements. Self-medication and over the counter (n = 213; 71.2%) were the most common dispensing and prescribing patterns (p = 0.001). Awareness rates about melatonin supplement pharmacokinetics and pharmacodynamics among community pharmacists were 38% and 37%, respectively. Despite its popularity, community pharmacists reported relatively low rates of awareness of melatonin supplement pharmacokinetics and pharmacodynamics. Further attention to this issue is needed.
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Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia
| | - Faris A. AlZahrani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Abdulrahman S. Hassan
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Abdullah H. Alirbidi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Osama A. Alraddadi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Omar A. AlSadah
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Mohammad B. Yamani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Sulafa T. Alqutub
- Department of Family and Community Medicine, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia;
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Zavaleta-Monestel E, Villalobos-Madriz JA, Serrano-Arias B, Arguedas-Chacón S, Diaz-Madriz JP, Ferreto-Meza MA, Romero-Chavarría BM, Zumbado-Amerling P. Assessing pharmaceutical consultations: Comparing pharmacy-recommended medications for minor ailments and regulatory compliance in a Latin American healthcare network. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100300. [PMID: 37521020 PMCID: PMC10371813 DOI: 10.1016/j.rcsop.2023.100300] [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] [Received: 03/16/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Background The importance of access to medicines in promoting global health cannot be overstated, particularly as an estimated 2 billion people lack access to basic medicines, particularly in developing nations. While over-the-counter (OTC) medications are relatively safe and cost-effective, there is a risk of misuse due to factors such as inaccurate self-diagnosis, inadequate dosing, addiction, adverse drug reactions, and drug interactions. To ensure proper use and prevent irrational self-medication, pharmacists can play a crucial role in guiding patients. However, the legislation in Costa Rica only covers OTC and prescription drugs, and health authorities are proposing a new decree to include a list of drugs that can be recommended by pharmacists without a prescription to treat minor ailments, which would be classified as behind-the-counter (BTC). Objective Characterize the pharmaceutical consultation, compare the medications recommended by pharmacy professionals for minor ailments with the legislation in force in Costa Rica, and determine whether the current OTC medications are sufficient to treat minor ailments. Material and methods This study is a descriptive, observational, cross-sectional study that focuses on a sample of the Costa Rican population that comes to consult with a pharmacist in one of the four pharmacies of the Hospital Clínica Bíblica (HCB) in San José, Costa Rica. Consultations included users over 18 years of age or caregivers of underage patients seeking advice or assistance from publicly accessible pharmacies, excluding consultations that involved information related to other hospital departments. This study aims to analyze the pharmaceutical consultation for minor ailments and compare the medications recommended by pharmacists with the list of medications allowed in Costa Rica. The study also aims to determine if the current OTC medications are adequate for treating minor ailments. Results A total of 1537 consultations were gathered, which were divided into four categories: pharmaceutical recommendation (48%), medication information (31%), other consultations (18%), and referrals to another health professional (3%). Among the consultations classified as pharmaceutical recommendations, 90% were related to minor ailments. Prescription drugs accounted for 75.3% of the medications recommended and consulted. However, when the BTC category was included, the percentage of recommended prescription drugs decreased to 29.6%, while BTC drugs constituted 45.7%. Finally, the chi-square test rejected the null hypothesis that there was no association between the availability of OTC drugs and the minor ailments for which patients sought consultation. Conclusions Most cases of pharmacy consultations involve minor illnesses such as digestive symptoms, joint pain, and respiratory issues. The proposed decree by health authorities in Costa Rica is noteworthy as it establishes standardized protocols for the prescription of BTC medications to ensure the safety of patients.
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Affiliation(s)
- Esteban Zavaleta-Monestel
- Department of Pharmacy, Hospital Clinica Biblica, San José, Costa Rica
- Faculty of Pharmacy, Universidad de Ciencias Médicas, San José, Costa Rica
| | | | - Bruno Serrano-Arias
- Department of Pharmacy, Hospital Clinica Biblica, San José, Costa Rica
- Faculty of Pharmacy, Universidad de Ciencias Médicas, San José, Costa Rica
| | | | - José Pablo Diaz-Madriz
- Department of Pharmacy, Hospital Clinica Biblica, San José, Costa Rica
- Faculty of Pharmacy, Universidad de Ciencias Médicas, San José, Costa Rica
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14
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Yan P, Li F, Nicholas S, Maitland E, Tan J, Chen C, Wang J. Impact of pension income on healthcare utilization of older adults in rural China. Int J Equity Health 2023; 22:166. [PMID: 37633941 PMCID: PMC10463592 DOI: 10.1186/s12939-023-01985-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE In China, rural residents experience poorer health conditions and a higher disease burden compared to urban residents but have lower healthcare services utilization. Rather than an insurance focus on enhanced healthcare services utilization, we aim to examine that whether an income shock, in the form of China's New Rural Pension Scheme (NRPS), will affect outpatient, inpatient and discretionary over-the-counter drug utilization by over 60-year-old rural NRPS residents. METHODS Providing a monthly pension of around RMB88 (USD12.97), NRPS covered all rural residents over 60 years old. Fuzzy regression discontinuity design (FRDD) was employed to explore the NRPS causal effect on healthcare services utilization, measured by outpatient and inpatient visits and discretionary over-the-counter drug purchases. The nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 provided the data. RESULTS Without significant changes in health status and medication needs, 60-plus-year-old NRPS recipients significantly increased the probability of discretionary OTC drug purchases by 33 percentage points. NRPS had no significant effect on the utilization of outpatient and inpatient utilization. The increase in the probability of discretionary OTC drug purchases from the NRPS income shock was concentrated in healthier and low-income rural residents. Robustness tests confirmed that FRDD was a robust estimation method and our results are robust. CONCLUSION NRPS was an exogenous income shock that significantly increased the probability of discretionary over-the-counter drug purchases among over 60-year-old rural residents, but not the utilization of inpatient or outpatient healthcare services. Income remains an important constraint for rural residents to improve their health. We recommend policymakers consider including commonly used over-the-counter drugs in basic health insurance reimbursements for rural residents; provide health advice for rural residents to make discretionary over-the-counter drug purchases; and to mount an information campaign on over-the-counter drug purchasing in order to increase the health awareness of rural residents.
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Affiliation(s)
- Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Fenghang Li
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, NSW, Australia
- Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | | | - Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Hubei Province, 115 Donghu Road, Wuhan, 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China.
- Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Hubei Province, Room A201, Wuhan, 430079, China.
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15
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Khan S, Griffin KW, Botvin GJ. Onset of the Non-Medical Use of Prescription and Over-the-Counter Medications during Early Adolescence: Comparison with Alcohol, Tobacco, and Marijuana. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1298. [PMID: 37628297 PMCID: PMC10453253 DOI: 10.3390/children10081298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
This study examined the prevalence and psychosocial predictors of the non-medical use of prescription and over-the-counter (OTC) medications and compared these to cigarette, marijuana, and alcohol use in a cohort of early adolescents (N = 1887) aged 11 to 13, a critical risk period for the initiation of substance use. Participants were students attending 22 middle schools in the northeastern United States. Participants completed surveys in the classroom, the first in the sixth grade and a second in the seventh grade, and the rate of overall substance use more than doubled from 5.5% to 11.9% over this period. Predictors of the onset of non-medical prescription and over-the-counter drug misuse overlapped substantially with those for marijuana and other substances. The perception of friends' substance use and the belief that substance use can help you deal with problems predicted the onset of marijuana use, OTC medication misuse, and prescription drug misuse. Decision-making skills were protective for the onset of all substance use outcomes. The findings of this study have important implications for prevention and suggest that a single comprehensive approach may be sufficient for preventing multiple forms of substance use onset during early adolescence.
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Affiliation(s)
- Sarosh Khan
- Department of Psychiatry, Boston University Medical Center, Boston, MA 02118, USA;
| | - Kenneth W. Griffin
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Gilbert J. Botvin
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10021, USA;
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16
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Koni A, Snobar A, Ahmed A, Jawabreh AAR, Al-Jabi SW, Zyoud SH. A Comparative Evaluation of Drug Information Leaflets of Over-the-Counter Medicines in Palestine. SAGE OPEN 2023; 13:215824402311797. [DOI: 10.1177/21582440231179762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Our study aims to conduct an evaluation and comparison between the leaflets of local and imported oral solid over-the-counter medications (OTC) found in the Palestinian markets. Forty-nine leaflets were evaluated using a scoring method and depending on the appearance of 31 headings, along with the use of manual word counting to assess the amount of information within 23 topics of all 31. None of the evaluated PIs, local or imported, completed all 31 criteria. Remarkably, the imported product leaflets achieved higher scores than their local leaflets in 19 out of 31 topics, whereas the local products achieved better scores than the imported agents in only 2 items, and 10 criteria were equally scored between them. None of the PIs mentioned pharmacokinetic information, instructions for converting tablets or capsules into liquid forms, or shelf life. In general, imported leaflets give more detailed information than their local counterparts. The lowest value of the fold difference in mean rank was 0.85 times for the direction of use, and the highest value was 2.43-fold for adverse drug reactions. The results showed a deficiency in the information provided in the local package inserts compared to the imported versions of oral solid OTC medications available in Palestine. These findings encourage the Palestinian Ministry of Health to provide full criteria for pharmaceutical companies to ensure that the leaflets contain sufficient and updated information and ensure that the patients use their drugs safely and effectively.
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Affiliation(s)
- Amer Koni
- An-Najah National University Hospital, Nablus, Palestine
- An-Najah National University, Nablus, Palestine
| | - Anas Snobar
- An-Najah National University, Nablus, Palestine
| | - Ahmad Ahmed
- An-Najah National University, Nablus, Palestine
| | | | | | - Sa’ed H. Zyoud
- An-Najah National University Hospital, Nablus, Palestine
- An-Najah National University, Nablus, Palestine
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17
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Chiappini S, Ceci F, Mosca A, Di Carlo F, Burkauskas J, Pettorruso M, Martinotti G, Guirguis A, Corkery JM, Scherbaum N, Schifano F, Di Giannantonio M. Knowledge and Use of Over-the-counter Drugs in Italy: An Exploratory Survey-based Study in the General Population. Curr Neuropharmacol 2023; 21:133-141. [PMID: 35838215 PMCID: PMC10193759 DOI: 10.2174/1570159x20666220714104231] [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: 05/29/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND During the past decade, the misuse of over-the-counter (OTC) medicines has become a global public health concern, especially among young people. In this study, we aimed to explore the OTC consumption and related misuse in Italy and identify the demographic characteristics of people/individuals involved in this phenomenon, understanding eventual risk factors. METHODS The study consisted of an anonymous online survey distributed by direct contact and via the Internet between June-November 2021 to the general population living in Italy. Descriptive statistics were reported, and binary regression analyses were performed to identify risk factors for lifetime misuse of OTC. The University of Hertfordshire approved the study (aLMS/SF/UH/02951). RESULTS The final sample size was composed of 717 respondents. The sample was mainly represented by female (69.3%) students (39.9%) in the 20-25 years age group (30.0%). Based on the survey responses, study participants were divided into two groups according to the presence/absence of OTC abuse/misuse (127 versus 590), which were compared for possible predictors of OTC diversion. Multivariate regression showed that OTC abuse/misuse was associated with the knowledge of the effects of OTC [odds ratio/OR = 2.711, 95%Confidence Interval/CI 1.794-4.097, p <0.001]. On the contrary, the educational level appeared to be a protective factor [OR = 0.695, 95%CI 0.58-0.94, p = 0.016]. CONCLUSION Although, according to our data, the phenomenon of OTC abuse appeared to be limited, increasing attention is needed because of possible underestimation and high-risk outcomes. Preventive strategies, including simplified access to information, may play a key role in limiting OTC misuse.
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Affiliation(s)
- Stefania Chiappini
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Franca Ceci
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Alessio Mosca
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Francesco Di Carlo
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Julius Burkauskas
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 00142 Palanga, Lithuania
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Amira Guirguis
- Swansea University Medical School, The Grove, Swansea University, Swansea, SA2 8PP, UK
| | - John M Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Massimo Di Giannantonio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
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18
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Ghemrawi R, Kharaba Z, Aldulaymi R, AlBataineh N, Alghaly F, Qasem N, Khair M. Expired medications and disposal practices in Arab households. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:534-540. [PMID: 35946835 DOI: 10.1093/ijpp/riac066] [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: 11/17/2021] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Over the past few decades, the accumulation of expired and unused medications in households has become a concern. Most people are unaware of how to properly dispose of unused and/or expired medicines. Our objective was to inspect the extent of expired medications within Arab households in United Arab Emirates (UAE), to determine which therapeutic groups yield greater amounts of unused medications, and evaluate drugs' disposal practices. METHODS This descriptive study was written in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist for cross-sectional studies. It was conducted among Arab households in UAE (n = 503) using an online questionnaire between November 2020 and January 2021. Questions were related to participants' socio-demographics, the prevalence of expired medications in households and their disposal. KEY FINDINGS Around 58% of the respondents had expired medications in their houses and 74% had drugs that were never used. The most common medicines left unused were analgesics (34%) followed by cosmetics (27%) and antibiotics (26%). More than 42% of expired medications were in solid dosage forms, 28% were semisolid and 24% were liquid dosage forms. The predominant disposal method among the surveyed participants was throwing medications into the garbage (86%). CONCLUSIONS Large quantities of expired medications in Arab households exist with a high prevalence of analgesics, antibiotics and cosmetics. Arab households are unaware of the proper drug disposal procedures. Therefore, community pharmacists are recommended to offer training on proper medication disposal practices and to encourage the public to return medications to pharmacies.
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Affiliation(s)
- Rose Ghemrawi
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Zelal Kharaba
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Raghad Aldulaymi
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Nezar AlBataineh
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Fady Alghaly
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Naji Qasem
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Mostafa Khair
- Core Technology Platforms, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Muacevic A, Adler JR, Alsaleh M, Atyia N, Alsmakh M, Alfaraj A, Alkhunaizi A, Alwabari J, Alzaidi M. Family, Individual, and Other Risk Factors Contributing to Risk of Substance Abuse in Young Adults: A Narrative Review. Cureus 2022; 14:e32316. [PMID: 36505959 PMCID: PMC9731175 DOI: 10.7759/cureus.32316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Substance use disorder and the availability of certain over-the-counter drugs are worldwide issues that affect many individuals, both mentally and physically. As a result, the frequent use of this substance can lead to substance abuse. This phenomenon is also becoming more prevalent with time, and it does not differentiate between genders, ages, races, or religions. This review aimed to provide an overview of studies related to substance abuse, the individuals who tend to abuse these substances, and their risk factors. We also aimed to discuss, identify, and analyze the factors that increase the risk of substance abuse among young adults. We performed a thorough search for related studies using PubMed to provide a comprehensive review of the risk factors and side effects experienced by young adults. The selected indexing terms included "substance abuse,""risk factors," and "personality traits," among others. Information was gathered from relevant peer-reviewed publications, and thereafter refined, and summarized.
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Affiliation(s)
| | | | | | - Nawaf Atyia
- Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Ali Alfaraj
- Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Jalal Alwabari
- Medicine, King Abdulaziz University Hospital, Jeddah, SAU
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20
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Self-medication among pregnant women in Ghana: A systematic review and meta-analysis. Heliyon 2022; 8:e10777. [PMID: 36217484 PMCID: PMC9547218 DOI: 10.1016/j.heliyon.2022.e10777] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/08/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Despite the associated health risks of self-medication during pregnancy, recent evidence suggests that the phenomena persist in most countries. However, self-medication during pregnancy in Ghana is poorly understood due to the lack of a comprehensive review study. Objectives We sought to review existing literature on the prevalence of self-medication, drugs used in self-medication, diseases associated with self-medication, and why pregnant women in Ghana self-medicate. Methods A comprehensive search was conducted in PubMed, Science Direct, African Journal Online (AJOL), Google Scholar, and the websites of Ghanaian universities to identify studies that were published until February 2022. We performed this review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A random-effects meta-analysis was done in StatsDirect statistical software and OpenMeta [Analyst] to estimate the prevalence of self-medication during pregnancy and was reported in a forest plot. Simple charts and tables were used to summarize evidence on drugs used in self-medication, diseases associated with self-medication, and reasons for self-medication. Results Six (6) studies met our inclusion criteria and the pooled prevalence of self-medication during pregnancy was 65.4% (95% CI = 58.2%–72.6%; I2 = 88.32%; p < 0.001). Common drugs used for self-medication included analgesics (48.1%) and herbal drugs (45.9%). Headache and lower abdominal pain were the most common conditions for which pregnant women self-medicated. The main reasons for self-medication were the perceived unserious nature of diseases, previous experience with drugs, and easy access to over-the-counter drugs. Conclusions Self-medication among pregnant women in Ghana is substantially high. Measures need to be implemented to reduce the high prevalence of self-medication during pregnancy to achieve sustainable development goals on maternal health in Ghana. A limitation of this study was the small number of included studies, which calls for more studies on self-medication during pregnancy in Ghana.
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Zhou Y, Li T, Zhou S, Xu H, Yin X, Chen H, Ni X, Bai M, Ao W, Yang J, Ahmed RG, Zhang X, Bao S, Yu J, Kwok KWH, Dong W. Pseudoephedrine hydrochloride causes hyperactivity in zebrafish via modulation of the serotonin pathway. Metab Brain Dis 2022; 37:2559-2568. [PMID: 35907131 DOI: 10.1007/s11011-022-01042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/17/2022] [Indexed: 10/16/2022]
Abstract
This study aimed to explore behavioral changes of embryonic and larval zebrafish caused by pseudoephedrine hydrochloride (PSE) and its underlying mechanism. Zebrafish embryos were exposed to 0.5 µM, 2 µM, and 8 µM PSE at 4 h post-fertilization (4 hpf) or 22-23 hpf. Mortality, hatching rate, coiling frequency, heart rate, behavior changes, and related gene expression were observed at different developmental stages. PSE below 8 µM did not affect zebrafish mortality, hatching rate, and heart rate compared with the control group. For embryos, PSE caused an increase at 16-32 hpf in zebrafish coiling frequency which could be rescued by serotonin antagonist WAY100635. Similarly, PSE caused an increase in the swimming distance of zebrafish larvae at 120 hpf. PSE also elevated the expression of serotonin (5-HT)-related genes 5-htr1ab and tph2 and dopamine-related gene dbh. Behavioral changes in zebrafish embryos and larvae caused by PSE may be closely associated with increased expression of 5-HT and dopamine-related genes. This may be reflected that the behavioral changes in zebrafish are a possible PSE monitoring indicator.
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Affiliation(s)
- Yini Zhou
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Tonglaga Li
- Affiliated Hospital of Inner Mongolia Minzu University, 028000, Tongliao, China
| | - Shangzi Zhou
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Han Xu
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Xiaoyu Yin
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Hao Chen
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Xuan Ni
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Meirong Bai
- College of Mongolian Medicine and Pharmacy, Inner Mongolia Minzu University, 028000, Tongliao, China
| | - Wuliji Ao
- College of Mongolian Medicine and Pharmacy, Inner Mongolia Minzu University, 028000, Tongliao, China
| | - Jingfeng Yang
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - R G Ahmed
- Division of Anatomy and Embryology, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Xuefu Zhang
- The Medical College of Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Shuyin Bao
- The Medical College of Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China
| | - Jianhua Yu
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China.
| | - Kevin W H Kwok
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
- Research Institute for Future Food, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wu Dong
- Inner Mongolia Key Laboratory of Toxicant Monitoring and Toxicology, College of Animal Science and Technology, Inner Mongolia Minzu University, 028000, Tongliao, Inner Mongolia, China.
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Carnovale C, Battini V, Gringeri M, Volonté M, Uboldi MC, Chiarenza A, Passalacqua G. Safety of fexofenadine and other second-generation oral antihistamines before and after the removal of the prescription requirement in Italy and other European countries: A real-world evidence study and systematic review. World Allergy Organ J 2022; 15:100658. [PMID: 35833202 PMCID: PMC9260294 DOI: 10.1016/j.waojou.2022.100658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/10/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Carla Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, 20157, Italy
| | - Vera Battini
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, 20157, Italy
| | - Michele Gringeri
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, 20157, Italy
| | - Marina Volonté
- Scientific Affairs Department, Sanofi, Milan, Italy
- Corresponding author. Marina Volonté, Sanofi, Viale Bodio 37/B, 20158 Milan (MI), Italy,
| | | | - Andrea Chiarenza
- Pharmacovigilance and Safety Department, Sanofi Italia & Malta MCO, Italy
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
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Vong SK, Kang L, Carter SR. Consumers' self-reported adherence to directions for non-prescription medicines and the role of risk perception. Res Social Adm Pharm 2022; 18:3929-3938. [PMID: 35729055 DOI: 10.1016/j.sapharm.2022.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 04/14/2022] [Accepted: 06/09/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Non-prescription medicines (NPMs), while relatively safe, are responsible for a small but significant proportion of medication misadventure and inappropriate use may lead to avoidable healthcare cost. Some consumers vary their use of NPMs from the directions provided on packaging or advice from healthcare professionals. Consumers may use NPMs at lower doses or less frequently than directed because of the risk of side effects. PURPOSE This study aimed to develop and validate a self-report measure for the extent to which consumers' follow directions (FDs) for NPMs. Secondly, it aimed to explore the relationship between risk perception towards NPMs and following directions. METHODS A cross-sectional study was administered online to participants who belong to an Australian agency which conducts consumer research. Participants were Australian adults who had used NPMs within the last month. Items for the FD-NPM scale were developed and validated. Exploratory factor analysis and confirmatory factor analysis were used to validate the FD-NPM scale. Structural equation modelling (SEM) was employed to explore the relationships between risk perception, covariates, and FDs. RESULTS There were 403 participants recruited. Less than 20% "always" or "often" self-reported following directions for dose, frequency, or duration of use. Factor analyses confirmed that there are two moderately positively correlated dimensions of FD-NPM (r = 0.46), which were named underuse and overuse. That is, consumers who self-reported underuse of non-prescription medicines were also more likely to self-report overuse. Consumers with high-risk perception towards NPMs, those who were younger and those who were more educated had a greater tendency to not follow directions. CONCLUSION A new self-report measure, the FD-NPM scale was developed and validated. That people who perceives NPMs to be harmful, tend to underuse and more concerningly, overuse them, is of great interest to clinicians and policymakers who are required to manage risk communications.
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Affiliation(s)
- Si Kei Vong
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Lifeng Kang
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Stephen R Carter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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24
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Algabbani AM, Alzahrani KA, Sayed SK, Alrasheed M, Sorani D, Almohammed OA, Alqahtani AS. The impact of using pictorial aids in caregivers’ understanding of patient information leaflets of pediatric pain medications: A quasi-experimental study. Saudi Pharm J 2022; 30:544-554. [PMID: 35693437 PMCID: PMC9177450 DOI: 10.1016/j.jsps.2022.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Patient information leaflets (PILs) are one of the main sources of information for over-the-counter medications (OTCs). This study aimed to assess caregivers' understanding of instructions in PILs provided with paracetamol medications and the impact of pictograms use. Methods A quasi-experimental study was conducted among caregivers of children aged < 13 years recruited in pediatric outpatient clinics at University Medical City in Riyadh. The calculated sample size was 128; at least 64 participants were needed in each group (the text-only group and the text-plus pictograms group). Caregivers' health literacy was assessed using a validated Arabic version of the Newest Vital Sign scale. Participants’ understanding of PILs instructions was assessed using eight questions on the route of administration, minimal hours between doses, max daily dose, shake medication before use, storage, and reporting adverse events; and was rated based on the number of questions correctly understood. Characteristics of participants were compared by Pearson X2 and t-test was used to assess the significance of mean score differences between groups. Results A total of 130 caregivers participated in the study; almost half of them were mothers (47%, [n = 61]) and 43% (n = 56) have “a possibility of limited health literacy”. The mean number of correct answers to questions assessing the understanding of PILs instructions was significantly higher among the text-plus pictograms group compared to the text-only group (5.25 ± 1.85 vs. 4.38 ± 1.27; p < 0.001). When results were controlled for age and gender, better health literacy was found to be associated with a better understanding of instructions (B = 0.39, 95 %CI 0.23–0.54). Conclusion Limited comprehension of medications instructions was observed; adding pictorial aids to PILs might enhance the comprehension. Differences in health literacy levels of caregivers should be considered when designing PILs.
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Affiliation(s)
- Aljoharah M. Algabbani
- Saudi Food and Drug Authority, Riyadh, Saudi Arabia
- Corresponding authors at: Pharmaceutical and Medical Devices Research Division, Executive Department of Research & Studies, Saudi Food and Drug Authority (SFDA), Northern Ring Branch Road, Hittin, Riyadh 13513, Saudi Arabia.
| | - Khalid A. Alzahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sarah K. Sayed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Deema Sorani
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar A. Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Co-corresponding author at: King Saud University, Riyadh, Saudi Arabia
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25
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Lima TACD, Peres MFP, Silberstein SD. Applicability of DSM-V substance use disorder (SUD) criteria in medication overuse headache (MOH). HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2021.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Medication overuse headache (MOH) is a chronic secondary headache disorder attributed to the frequent or regular use of analgesics or acute antimigraine drugs in patients with a primary headache disorder. In addition, it has been linked to substance use disorder (SUD) also known as drug addiction, a persistent use of drugs or substances, despite substantial damage and adverse consequences, diagnosed by DSM-V criteria. At this time, apart from opioids, acute headache medications are not included in SUD. Despite the idea that the compulsive search for reward in MOH is similar to that observed in substance dependence, the DSM-V SUD criteria have never been carefully applied to MOH. We propose to discuss each DSM-V criterion of SUD diagnosis to see whether it is appropriate to use in MOH. We considered it was not-applicable when dealing with a situation that could be explained both by addictive behavior and by poorly controlled primary headache. We conclude that the SUD criteria should not be applied to patients who meet the criteria for MOH.
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26
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Magadmi M, Magadmi R, Kamel F, Hagras M, Alhmied H, Aljumaiy W, Saqat D. Knowledge and attitudes regarding the self-use of pain medications in Saudi Arabia: A cross-sectional study. J Microsc Ultrastruct 2022; 10:15-19. [PMID: 35433258 PMCID: PMC9012407 DOI: 10.4103/jmau.jmau_47_20] [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: 06/08/2020] [Accepted: 08/13/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: The objective of the study was to examine the knowledge and attitudes of the population in the Kingdom of Saudi Arabia regarding the use of over-the-counter (OTC) analgesics. Methods: A prospective cross-sectional study used an electronic survey questionnaire comprising 18 questions. An electronic survey was distributed through social networking sites during the period from November 1 to November 15, 2014, followed by data analysis. Results: Data from 1808 questionnaires were collected and analyzed. The results showed that 61% of the participants used analgesics without prescription; 67% used analgesics only for severe pain; 72% stated that analgesics could be administered with other medications; 68% reported that analgesics had an antipyretic effect; and only 1% reported that they had an anti-inflammatory effect. Further, 80% of the participants had the habit of reading drug product information and 77% were careful about the expiry date. Conclusions: The general population showed inadequate knowledge and attitudes toward OTC analgesics. Therefore, more programs to increase awareness and health education among patients are needed.
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27
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Rauschert C, Seitz NN, Olderbak S, Pogarell O, Dreischulte T, Kraus L. Abuse of Non-opioid Analgesics in Germany: Prevalence and Associations Among Self-Medicated Users. Front Psychiatry 2022; 13:864389. [PMID: 35546935 PMCID: PMC9081647 DOI: 10.3389/fpsyt.2022.864389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Abuse of non-opioid analgesics (NOA) is associated with serious health consequences. However, due to inconsistent definitions of NOA abuse, prevalence estimates for the German population are unclear. OBJECTIVES This study aimed to estimate the 12-month prevalence of NOA abuse among self-medicated users of these drugs in the general German population and to identify risk factors. METHODS Data are from the 2015 Epidemiological Survey of Substance Abuse, a nationally representative sample with 9,204 individuals aged 18-64 years. Classification of NOA abuse was based on self-reported information according to the definition of the ICD-10-GM diagnosis F55.2 abuse of non-dependence producing substances. Multiple logistic regression was performed to examine associations between NOA abuse and sociodemographic, behavioral, and health-related variables. RESULTS The weighted 12-month prevalence of NOA abuse was 14.6% (95%-CI [13.2- 16.0]) among self-medicated users of these drugs. Extrapolation of the proportion of individuals abusing NOA to the German population aged 18 to 64 is 3,243,396 individuals or 6.4% (95%-CI [5.7- 7.1]). Inexplicable physical pain, being underweight, depression, hazardous alcohol use, daily smoking, illegal drug use, and frequent use of NOA (one or more times per week and daily use) were associated with an increased probability of NOA abuse. The use of cannabis was associated with a lower probability of NOA abuse. CONCLUSION Abuse of NOA is highly prevalent in the German population. Against the background of increasing self-medication of NOA, healthcare providers need to be aware of potential risk factors of abuse to better identify and prevent this problem.
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Affiliation(s)
- Christian Rauschert
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany
| | - Nicki-Nils Seitz
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany
| | - Sally Olderbak
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany.,Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tobias Dreischulte
- Department of General Practice and Family Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Ludwig Kraus
- Department of Epidemiology and Diagnostics, IFT Institut für Therapieforschung, Munich, Germany.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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28
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Kumar A, Soni P. Is pheniramine dependence associated with secondary psychiatric syndrome? A case report. ARCHIVES OF MENTAL HEALTH 2022. [DOI: 10.4103/amh.amh_63_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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29
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Stefania C, Andrea M, Alessio M, Mauro P, Amira G, Martin CJ, Giovanni M, Massimo DG, Fabrizio S. The Benzydamine Experience: A Systematic Review of Benzydamine Abuse. Curr Neuropharmacol 2021; 19:1728-1737. [PMID: 33441070 PMCID: PMC8977632 DOI: 10.2174/1570159x19666210113151136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/08/2020] [Accepted: 12/19/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Both prescription and over-the-counter (OTC) drugs recently emerged among novel psychoactive substances (NPS) being reported as ingested for recreational purposes. Among them, benzydamine (BZY), normally prescribed as an OTC anti-inflammatory drug, is reportedly being diverted and recreationally used. OBJECTIVE The aim of this study was to investigate how the misuse of BZY has been reported, illustrating its psychotropic molecular mechanism, and studying its psychopathological effects. METHODS We firstly conducted a systematic review of the literature concerning the abuse of BZY and its effects. For data gathering purposes, both PRISMA and PROSPERO guidelines were followed. All research methods were approved by PROSPERO (identification code CRD42020187266). Second, we analysed BZY-related data from the European Monitoring Agency (EMA) Adverse Drug Reactions (ADRs) database recorded during 2005-2020 regarding its abuse. RESULTS Eleven articles, published during 1997-2019, were included in our systematic review, including five case reports, four surveys, and two retrospective case series analyses. While nine articles dealt with the recreational use of BZY, two described an oral overdose of the drug. When specified, dosages of BZY consumed ranged from 500 to 1500mg. The EMA dataset contained three cases of BZY abuse. CONCLUSION Results from the systematic review showed BZY might be diverted for typical hallucinogenic properties occurring at high dosages. Healthcare professionals should be warned about a possible misuse/abuse of a commonly prescribed anti-inflammatory drug and be vigilant when prescribing it. Physicians working in emergency units should know that psychotic symptoms may be related to BZY abuse.
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Affiliation(s)
- Chiappini Stefania
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Miuli Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio, Chieti-Pescara, Italy
| | - Mosca Alessio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio, Chieti-Pescara, Italy
| | - Pettorruso Mauro
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio, Chieti-Pescara, Italy
| | - Guirguis Amira
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Corkery John Martin
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Martinotti Giovanni
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio, Chieti-Pescara, Italy
| | - Di Giannantonio Massimo
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio, Chieti-Pescara, Italy
| | - Schifano Fabrizio
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
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30
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Algarni M, Hadi MA, Yahyouche A, Mahmood S, Jalal Z. A mixed-methods systematic review of the prevalence, reasons, associated harms and risk-reduction interventions of over-the-counter (OTC) medicines misuse, abuse and dependence in adults. J Pharm Policy Pract 2021; 14:76. [PMID: 34517925 PMCID: PMC8439034 DOI: 10.1186/s40545-021-00350-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/23/2021] [Indexed: 12/03/2022] Open
Abstract
Background Over-the-counter (OTC) medicines are typically safe. However, there is evidence that OTC medicines can sometimes cause harm as a result of their misuse, abuse and dependence. Aim of the review To review the literature on OTC medicines misuse, abuse and dependence in adults and identify the implicated medicines, contributing factors, associated harms and risk-mitigating interventions. Methods Following PRISMA guidelines, electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, MEDLINE, PsycINFO Web of Science and Google Scholar were searched for peer-reviewed journal articles published in English between January 2011 and March 2019. Quantitative, qualitative and mixed-methods studies assessing aspects of misuse, abuse and dependence of OTC medicines in individuals aged 18 years or more were included. Studies that solely focused on adolescents only, doping in sports or abuse of OTC medicines in people who are substance abusers were excluded. The random effect meta-analysis model was used to pool the prevalence among the population-based studies. Results Of 2355 peer-reviewed studies initially identified, 53 were included in this review. According to the study design, the prevalence varied, but the overall pooled prevalence in the population-based studies was: 16.2% for misuse, 2.0% for abuse, and 7.2% for dependence. The common OTC medicines groups involved in the problematic use were analgesics (with or without codeine), sedative antihistamines, cough mixtures containing dextromethorphan. Physical, psychological, social and financial harms were associated with problematic use of OTC medicines in addition to hospitalisation and death. Interventions for the affected individuals were provided mainly through the community pharmacies, general practices and specialised addiction centres. Conclusion The problematic use of OTC medicines is quite prevalent in adults, necessitating raising public awareness about their safe use. In addition, innovative harm minimisation models need to be developed, evaluated and implemented across health care settings. Supplementary Information The online version contains supplementary material available at 10.1186/s40545-021-00350-7.
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Affiliation(s)
- Mohammad Algarni
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Birmingham, UK.
| | - Muhammad Abdul Hadi
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Birmingham, UK
| | - Asma Yahyouche
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Birmingham, UK
| | - Sajid Mahmood
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Birmingham, UK
| | - Zahraa Jalal
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Birmingham, UK
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31
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Jouanjus E, Gibaja V, Fabre F, Lapeyre-Mestre M. Medical prescription forms of opioid cough suppressants falsified by the patients before and after they switched from OTC to prescription-only in France. Br J Clin Pharmacol 2021; 88:1713-1721. [PMID: 34427950 DOI: 10.1111/bcp.15052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The French Ministry of Health scheduled opioid cough suppressants as prescription-only drugs on July 12th , 2017. The present study assessed the impact of this regulation on the diversion modalities of the concerned drugs and the related drug pholcodine by analysing the national OSIAP (Ordonnances suspectes indicateur d'abus possible) database. METHODS Medical prescriptions with at least one mention of codeine, dextromethorphan, ethylmorphine, noscapine or pholcodine for cough suppression recorded in 2013-2019 were extracted from OSIAP. Annual mentioning rates were estimated by dividing numbers of mentions over those of prescriptions recorded the year considered. A descriptive analysis compared the characteristics of prescriptions before and after July 12th , 2017. RESULTS Overall, 832 mentions of the requested drugs were retrieved on 827 prescription forms. Codeine was the most frequent (n=809, 8.7%) with 6 additional mentions of codeine/ethylmorphine combination, followed by dextromethorphan (n=11, 0.1%) and pholcodine (n=6, 0.1%). There was no mention of noscapine. Annual mentioning rates varied between 0 and 0.3% for all drugs except codeine. Codeine mentioning rates ranged between 0.3% (n=2) and 0.7% (n=9) before July 12th , 2017 and increased to 10.1% (n= 61) thereafter in 2017, 16.1% (n=314) in 2018, and 19.8% (n=414) in 2019. The profile of subjects evolved accordingly with an arisen male/female ratio (10.0 versus 1.5 before), a younger age (23 years versus 40 before, p<0.001). DISCUSSION The sharp increase of recourse to falsified prescription forms indicates that codeine diversion continues despite a restricted access, whereas the other drugs studied do not seem to have been impacted.
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Affiliation(s)
- Emilie Jouanjus
- Addictovigilance Centre, Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France.,CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Valérie Gibaja
- Addictovigilance Centre, Nancy University Hospital, Vandoeuvre les Nancy, France
| | - Florence Fabre
- Addictovigilance Centre, Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
| | - Maryse Lapeyre-Mestre
- Addictovigilance Centre, Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
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32
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Phaugat P, Nishal S, Dhiman R. Abuse Deterrent Formulations in Constraining the Abuse Potential of Prescription Medicines: A Myth or Truth. Curr Drug Deliv 2021; 19:466-478. [PMID: 34353262 DOI: 10.2174/1567201818666210805145819] [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: 12/19/2020] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diverse pain killers used for the management of varied categories of pain are being misused in order to have extreme pleasant effect by a large number of populations. To overcome the misuse of prescription drugs, regulatory bodies have given stress on development of abuse resistance. METHODS We studied numerous literatures: (1) Research and review papers including the guidelines for pain management, abuse, and abuse deterrence; (2) Description and categorization of pain along with the management approaches; (3) advantages and disadvantages of the abuse deterrent formulations were described. RESULTS Abuse deterrent formulations are the contemporary remedial treatment for pain with reduced prospects of being abused. But these comprise the huge expense in contrast to the generic drugs as well as the non-deterrent branded equivalents. CONCLUSION Many challenges are faced throughout the development of abuse deterrent formulations. These formulations displayed substantial drop in abuse incidences but it may lead to other modes of abuse which may prove more harmful for the users.
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Affiliation(s)
- Parmita Phaugat
- Drug Safety Associate; Pharmacovigilance, Parexel International. India
| | - Suchitra Nishal
- College of Pharmacy, University of Health Sciences Rohtak. India
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33
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Ophthalmic Drug Abuse: Knowledge, Attitude, and Practice of Ophthalmologists in Jordan. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-019-00216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Chiappini S, Schifano F, Corkery JM, Guirguis A. Beyond the 'purple drank': Study of promethazine abuse according to the European Medicines Agency adverse drug reaction reports. J Psychopharmacol 2021; 35:681-692. [PMID: 33427017 PMCID: PMC8278560 DOI: 10.1177/0269881120959615] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Promethazine is a medicinal product, available on its own or in combination with other ingredients including dextromethorphan, paracetamol and/or expectorants. Anecdotal reports have however indicated that promethazine may have a misuse potential, especially in adolescents. OBJECTIVE We here aimed at studying how this phenomenon has been reported to the European Monitoring Agency Adverse Drug Reactions database. METHODS After a formal request to the European Monitoring Agency, the promethazine-specific dataset has been studied, performing a descriptive analysis of misuse/abuse/dependence-related adverse drug reaction reports. The study was approved by the University of Hertfordshire (LMS/PGR/UH/03234). RESULTS The analysis of promethazine data showed increasing levels of misuse/abuse/ dependence issues over time (2003-2019). Out of a total number of 1543 cases of adverse drug reactions, the abuse/misuse/dependence-related cases reported were 557, with 'drug abuse' (300/557: 53.8%) and 'intentional product misuse' (117/557: 21.0%). being the most represented adverse drug reactions. A high number of fatalities were described (310/557: 55.6%), mostly recorded as 'drug toxicity/drug abuse' cases, with opiates/opioids having been the most commonly reported concomitant drugs used. CONCLUSION Anecdotal promethazine misuse/abuse reports have been confirmed by European Monitoring Agency data. Promethazine misuse/abuse appears to be an alarming issue, being associated with drug-related fatalities. Thus, healthcare professionals should be warned about a possible misuse of promethazine and be vigilant, as in some countries medicinal products containing promethazine can be purchased over the counter. Since promethazine is often available in association with opioids, its abuse may be considered a public health issue, with huge implications for clinical practice.
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Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK,Fabrizio Schifano, Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire AL10 9AB, UK.
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK
| | - Amira Guirguis
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
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Oyekan PJ, Gorton HC, Copeland CS. Antihistamine-related deaths in England: Are the high safety profiles of antihistamines leading to their unsafe use? Br J Clin Pharmacol 2021; 87:3978-3987. [PMID: 33729599 DOI: 10.1111/bcp.14819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/26/2021] [Accepted: 02/10/2021] [Indexed: 01/26/2023] Open
Abstract
AIMS Antihistamines are routinely taken to control allergic reactions or sedation to induce sleep. There are, however, growing concerns regarding sedating antihistamine misuse. This research aims to evaluate deaths related to antihistamines in England occurring during 2000-2019. METHODS Cases reported to the National Programme on Substance Abuse Deaths from England occurring in 2000-2019 with antihistamine detections at postmortem were extracted for analysis. RESULTS In total, 1666 antihistamine postmortem detections were identified from 1537 cases. Sedating antihistamines available for purchase under pharmacist supervision but without need for a prescription (pharmacy-only medications) were present in a significant majority of cases (85.2%, P < .01). Despite an increasing trend for antihistamine-related deaths over time, the proportion of deaths where an antihistamine was implicated declined over the same period. Specific concerns with regards to the misuse of these pharmacy-only sedating antihistamines are raised with regards to the significant proportion of cases that were concluded as suicide (20.9%, P < .01), and the high prevalence of their use in combination with other central nervous system depressants (94.8% of cases). CONCLUSION This is the first report in over 40 years regarding antihistamine-related mortality from England. The rising trend in sedating antihistamine-related deaths may be contributed to by their increasing availability and the perceived negligible dangers associated with antihistamines, both from the general public and learned professionals. Awareness of the dangerous sedative properties that some antihistamines possess is, however, heightened in individuals deliberately seeking these effects. Urgent review of sedating antihistamines currently assigned under the pharmacy-only classification is needed to achieve antihistamine harm reduction.
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Affiliation(s)
- Princess J Oyekan
- Institute of Pharmaceutical Sciences, King's College London, London, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Caroline S Copeland
- Institute of Pharmaceutical Sciences, King's College London, London, UK.,Population Health Research Institute, St George's, University of London, London, UK
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Al Mazrouei N, Ibrahim RM, Al Meslamani AZ, Abdel-Qader DH, Mohamed Ibrahim O. Virtual pharmacist interventions on abuse of over-the-counter medications during COVID-19 versus traditional pharmacist interventions. J Am Pharm Assoc (2003) 2021; 61:331-339. [PMID: 33676838 PMCID: PMC7879024 DOI: 10.1016/j.japh.2021.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/24/2021] [Accepted: 02/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the frequency, nature, and clinical significance of pharmacist interventions on over-the-counter (OTC) medicines with abuse potential across community pharmacies with and without virtual care. METHODS In this prospective observational study, a trained research team observed the dispensary teams of 12 community pharmacies in the United Arab Emirates (UAE), 6 of which were operating virtual pharmacy care. A standardized data collection form was used to include information about dispensing of OTC medicines and pharmacist interventions on those with abuse/misuse potential. The clinical significance of the interventions was evaluated by a multidisciplinary committee. RESULTS The frequency of pharmacist interventions on OTC medicines with abuse potential across pharmacies with and without virtual services was 83.2% versus 91.0%, respectively, whereas the frequency of pharmacist interventions on OTC medicines with misuse potential across pharmacies with and without virtual services was 79.8% versus 41.2%, respectively. The proportions of clinically significant interventions across pharmacies with and without virtual services were 19.7% versus 10.5%, respectively. Cough medicines were dispensed significantly more across pharmacies with virtual care than across pharmacies without virtual care (25.6% vs. 9.7%, respectively; P = 0.04). Asking the patient to seek the advice of an addiction specialist (adjusted odds ratio = 4.11; P = 0.001) versus refusing to sell the drug was more likely to be associated with pharmacies with virtual services than with pharmacies operating traditional pharmacy services. CONCLUSION Virtual pharmaceutical care is a potential approach to reduce the abuse/misuse of OTC medicines but needs some improvements regarding detection of these cases. The UAE is the first country in the region to implement and regulate virtual pharmacy practice.
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Veiga P, Cavaco AM, Lapão LV, Guerreiro MP. Self-medication consultations in community pharmacy: an exploratory study on teams' performance, client-reported outcomes and satisfaction. Pharm Pract (Granada) 2021; 19:2138. [PMID: 33628343 PMCID: PMC7886312 DOI: 10.18549/pharmpract.2021.1.2138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/31/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Community pharmacy teams (CPTs) have an established role in assisting
self-medication, contributing to the safe and effective use of
non-prescription medicines. Objective: The study aimed to describe CPTs’ performance in self-medication
consultation, client-reported outcomes, and satisfaction. A secondary
purpose was to develop an explanatory model for better understanding
clients’ satisfaction with this service. Methods: Descriptive, cross-sectional exploratory study. Data were collected in a
purposive sample of pharmacy clients recruited in six community pharmacies
in Portugal. CPTs adopted a structured approach to self-medication
consultations, encompassing 11 quality criteria (five for case evaluation
and six for counselling). An evaluation score, a counselling score and an
overall quality score were estimated. Client-reported outcomes and
satisfaction were ascertained via a follow-up telephone interview. Besides
descriptive statistics, the association with several independent variables
on the clients’ overall satisfaction was explored, using linear
regression. Results: Product-based dispensing was more frequent for lower educated clients.
Reported compliance with the criteria by CPTs was overall high
(93.95% of maximum compliance), mostly missing the ‘other
medication’ questioning. Most clients (93%) reported
improvement after the consultation. Clients’ satisfaction score was
4.70 out of 5. The variables that seem to better explain clients’
overall satisfaction are pharmacy loyalty, the evaluation score, and the
female gender. Conclusions: Clients’ reported outcomes were favourable, as well as satisfaction
with the service. Clients’ satisfaction appears to be determined by
consultation quality (evaluation score), suggesting the advancement of the
pharmacists’ clinical role. A larger study is warranted to confirm
these findings.
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Affiliation(s)
- Paulo Veiga
- PhD. Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon . Lisbon ( Portugal ).
| | - Afonso M Cavaco
- PhD. Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon . Lisbon ( Portugal ).
| | - Luís V Lapão
- PhD. Institute of Hygiene and Tropical Medicine (IHMT), Comprehensive Healthcare Research Center (CHRC) & Research and Development Unit in Mechanical and Industrial Engineering (UNIDEMI), Nova University Lisbon . Lisbon ( Portugal ).
| | - Mara P Guerreiro
- PhD. (CiiEM) Egas Moniz University Institute . Monte de Caparica ( Portugal ).
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Yehya A, Numan M, Matalqah L. No Time for Lullabies Tracing down Pharmacological Effects & Uses of H1-Antihistamines in Children Younger than 6 Years. Glob Pediatr Health 2021; 8:2333794X21992170. [PMID: 33748342 PMCID: PMC7903821 DOI: 10.1177/2333794x21992170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives. To provide a qualitative and a quantitative analysis of H1-antihistamines pharmacological uses pattern among children (<6 years old) and to evaluate the parental-related awareness. Methods. A cross-sectional study was carried out at 5 retail pharmacies in Jordan over 5 months (October/2019-February/2020). Parents who requested any of H1-antihistmine agent for a child (<6 years) were invited to participate. Results. A total of 516 children, most of them were toddlers (1-3) years, received at least 1 H1-antihistamine. More than half of the cases received H1-antihistamine as self-medication (56.3%). Sedating antihistamine agents were the most frequently used among children (<6 years old) (77.9%) among which Chlorpheniramine maleate was the most commonly used agent (62.9%). About half of the children (47.0%) received H1-antihistamine to induce sleep. Whereas, 21.7% and 12.9% received them to manage flu, and allergic rhinitis (AR), respectively. Around 66.6% of the cases were classified as off-label use. Most of the parents (80.5%) were aware of the sedative adverse effects of H1-antihistamines, whereas a fewer number (31.9%) were aware of their cognitive effects. Finally, more than two thirds of parents (79.7%) were unfamiliar with off-label drug use in children. Conclusion. Despite the availability of less-sedating H1-antihistamines with a wide safety and efficacy record, the use of sedating H1-antihistamines remains popular in children.
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Affiliation(s)
| | - Mohammad Numan
- Jordan University of Science and Technology (JUST), Irbid, Jordan
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Kawuma R, Chimukuche RS, Francis SC, Seeley J, Weiss HA. Knowledge, use (misuse) and perceptions of over-the-counter analgesics in sub-Saharan Africa: a scoping review. Glob Health Action 2021; 14:1955476. [PMID: 34420494 PMCID: PMC8386732 DOI: 10.1080/16549716.2021.1955476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Over-the-counter (OTC) analgesics are safe for pain-management when used as recommended. Misuse can increase the risk of hypertension and gastrointestinal problems. OBJECTIVE To conduct a scoping review of the uses and misuses of OTC analgesics in sub-Saharan Africa, to inform strategies for correct use. METHOD Following guidelines for conducting a scoping review, we systematically searched Pubmed, ResearchGate and Google Scholar databases for published articles on OTC analgesic drug use in sub-Saharan Africa, without restrictions on publication year or language. Search terms were 'analgesics', 'non-prescription drugs', 'use or dependence or patterns or misuse or abuse' and 'sub-Saharan Africa'. Articles focusing on prescription drugs were excluded. RESULTS Of 1381 articles identified, 35 papers from 13 countries were eligible for inclusion. Most were quantitative cross-sectional studies, two were mixed-methods studies, and one used qualitative methods only. About half (n = 17) the studies recorded prevalence of OTC drug use above 70%, including non-analgesics. Headache and fever were the most common ailments for which OTC drugs were taken. Primary sources of OTC drugs were pharmacy and drug shops, and family, friends and relatives as well as leftover drugs from previous treatment. The main reasons for OTC drug use were challenges in health service access, perception of illness as minor, and knowledge gained from treating a previous illness. Information regarding self-medication came from family, friends and neighbours, pharmacies and reading leaflets either distributed in the community or at institutions of learning. OTC drug use tended to be more commonly reported among females, those with an education lower than secondary level, and participants aged ≥50 years. CONCLUSION Self-medicating with OTC drugs including analgesics is prevalent in sub-Saharan Africa. However, literature on reasons for this, and misuse, is limited. Research is needed to educate providers and the public on safe use of OTC drugs.
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Affiliation(s)
- Rachel Kawuma
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rujeko Samanthia Chimukuche
- Social Science and Research Ethics Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Suzanna C Francis
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Janet Seeley
- Social Aspects of Health Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Social Science and Research Ethics Department, Africa Health Research Institute, KwaZulu-Natal, South Africa.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen A Weiss
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Schifano F, Chiappini S, Miuli A, Mosca A, Santovito MC, Corkery JM, Guirguis A, Pettorruso M, Di Giannantonio M, Martinotti G. Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants. Front Psychiatry 2021; 12:657397. [PMID: 34025478 PMCID: PMC8138162 DOI: 10.3389/fpsyt.2021.657397] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Over the past 20 years or so, the drug misuse scenario has seen the emergence of both prescription-only and over-the-counter (OTC) medications being reported as ingested for recreational purposes. OTC drugs such as antihistamines, cough/cold medications, and decongestants are reportedly the most popular in being diverted and misused. Objective: While the current related knowledge is limited, the aim here was to examine the published clinical data on OTC misuse, focusing on antihistamines (e.g., diphenhydramine, promethazine, chlorpheniramine, and dimenhydrinate), dextromethorphan (DXM)- and codeine-based cough medicines, and the nasal decongestant pseudoephedrine. Methods: A systematic literature review was carried out with the help of Scopus, Web of Science databases, and the related gray literature. For data gathering purposes, both the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and PROSPERO guidelines were followed (PROSPERO identification code CRD42020209261). Results: After completion of the selection, eligibility, and screening phases, some 92 articles were here taken into consideration; case reports, surveys, and retrospective case series analyses were included. Findings were organized according to the specific OTC recorded. Most articles focused here on DXM (n = 54) and diphenhydramine (n = 12). When specified, dosages, route(s) of administration, toxicity symptoms (including both physical and psychiatric ones), and outcomes were here reported. Conclusion: Results from the systematic review showed that the OTC misusing issues are both widespread worldwide and popular; vulnerable categories include adolescents and young adults, although real prevalence figures remain unknown, due to a lack of appropriate monitoring systems. Considering the potential, and at times serious, adverse effects associated with OTC misusing issues, healthcare professionals should be vigilant, and ad hoc preventative actions should be designed and implemented.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Maria Chiara Santovito
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - John M Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Amira Guirguis
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, United Kingdom
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
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Vinnakota DN, Kamatham R. Effect of proton pump inhibitors on dental implants: A systematic review and meta-analysis. J Indian Prosthodont Soc 2020; 20:228-236. [PMID: 33223692 PMCID: PMC7654198 DOI: 10.4103/jips.jips_283_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/11/2020] [Accepted: 02/24/2020] [Indexed: 01/15/2023] Open
Abstract
Aim The present systematic review aims to determine the evidence on the impact of proton pump inhibitors (PPIs) on dental implants. Settings and Design This secondary qualitative and quantitative research was done using a pre-specified question and inclusion criteria. Materials and Methods A systematic search was conducted in electronic databases such as PubMed, Ovid, and Cochrane. All the studies that assessed the effect of PPIs on dental implants were included, irrespective of the design. Literature review, letter to editors, short commentaries, and opinion articles were excluded. Results and Statistical Analysis Used A total of three publications fulfilled the inclusion criteria. All these included articles were retrospective cohort studies; the methodological quality was assessed using Newcastle-Ottawa scale. A total of 452 implants were placed in 149 PPI users, whereas 6798 were positioned in 2241 nonusers. Of these, 43 and 212 implants failed in users and nonusers, respectively (odds ratio: 2.91, 95% confidence interval: 2.06-4.11). The meta-analysis was performed using the statistical software Review Manager, and a fixed-effect model was used to obtain the odds ratio. The success rate of implants based on age, gender, smoking, and bone augmentation could be combined only from two studies, which revealed a considerable effect of these factors. Conclusion As far as the available evidence is considered, it seems as if the usage of PPI has a detrimental effect on the success of dental implants. This influence needs justification as none of the included studies segregated the data based on confounding factors. Hence, there is a need to conduct well-designed, prospective, randomized clinical trials with balanced confounding factors to derive a proper conclusion.
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Affiliation(s)
- Dileep Nag Vinnakota
- Department of Prosthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
| | - Rekhalakshmi Kamatham
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College, Nellore, Andhra Pradesh, India
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Makowska M, Boguszewski R, Nowakowski M, Podkowińska M. Self-Medication-Related Behaviors and Poland's COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228344. [PMID: 33187315 PMCID: PMC7696561 DOI: 10.3390/ijerph17228344] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
(1) Background: The SARS-CoV-2 pandemic has changed the functioning of Polish health systems. Telemedicine has been developed and access to prescription drugs (Rx) has been facilitated. This study examined whether these changes and the imposition of a three-month lockdown caused Polish people to engage in more self-medication-related behaviors. (2) Method: After the fourth (final) stage of defrosting the Polish economy, an online survey of a quota sample of 1013 Polish respondents was conducted. (3) Results: Almost half of the respondents (45.6%) indicated that they had engaged in at least one behavior associated with inappropriate self-medication during the lockdown (e.g., 16.6% took medication as a precaution, and 16.8% took an Rx formulation without consultation). Some of these people had never engaged in such behaviors prior to the lockdown. Linear regression showed that higher values of a composite ("lockdown") index of self-medication-related behaviors occurring during lockdown were predicted by greater religiosity and the presence of children in a household. Also, independent samples t-tests showed that people who were afraid for their financial future and people who feared for their health obtained higher lockdown index scores than people not having such worries. (4) Conclusions: Self-medication-related behaviors were more common among Poles before lockdown than during the lockdown (which is unsurprising given that the lengths of the periods compared were hugely different), worryingly, many people exhibited such behaviors for the first time during the lockdown.
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Affiliation(s)
- Marta Makowska
- Institute of Sociological Sciences and Pedagogy, Warsaw University of Life Sciences, Nowoursynownska 166 St. 02-787 Warsaw, Poland; (M.M.); (M.P.)
| | - Rafał Boguszewski
- Institute of Sociological Sciences and Pedagogy, Warsaw University of Life Sciences, Nowoursynownska 166 St. 02-787 Warsaw, Poland; (M.M.); (M.P.)
- Correspondence:
| | - Michał Nowakowski
- Department of Social Health Problems, Maria Curie-Skłodowska University in Lublin, Plac Marii Curie-Skłodowskiej 5, 20-031 Lublin, Poland;
| | - Monika Podkowińska
- Institute of Sociological Sciences and Pedagogy, Warsaw University of Life Sciences, Nowoursynownska 166 St. 02-787 Warsaw, Poland; (M.M.); (M.P.)
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Wazaify M, Alhusein N, Scott J. Qualitative exploration of the experiences of men who use drugs of obtaining psychoactive medicinal products in Jordan. J Ethn Subst Abuse 2020; 21:1-17. [PMID: 33121396 DOI: 10.1080/15332640.2020.1836702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In Jordan, almost any medication can be bought from pharmacies. This ready availability is linked with abuse. Previous literature describes medicine abuse from pharmacists' and general public perspectives. Here we investigate experiences of 17 men in addiction treatment in Amman (21-39 years) of obtaining psychoactive medicines. Alprazolam, clonazepam, bromazepam and tramadol were most commonly abused. Psychoactive medicines were obtained from street dealers, but pharmacies were preferred. Regulations appears ineffective; lack of understanding of pharmacists of the abuse potential of some medicines was perceived; 'softening rules' on supply was attributed to cultural and social norms around familiarity.
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Mody S, Kirkdale CL, Thornley T, Dickinson A, Avery AJ, Knaggs R, Rann S, Bastable R. Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use? PHARMACY 2020; 8:pharmacy8040185. [PMID: 33049965 PMCID: PMC7712583 DOI: 10.3390/pharmacy8040185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 01/23/2023] Open
Abstract
The misuse of opioids, including codeine which is sold over-the-counter (OTC) in United Kingdom (UK) community pharmacies, is a growing public health concern. An educational Patient Safety Card was developed and piloted to see if it nudged customers into the safe and appropriate use of OTC codeine. Exploratory analysis was conducted by (i) recording quantitative interactions for people requesting OTC codeine in community pharmacies; and (ii) a web-based pharmacy staff survey. Twenty-four pharmacies submitted data on 3993 interactions using the Patient Safety Card. Staff found the majority of interactions (91.3%) to be very or quite easy. Following an interaction using the card, customers known to pharmacy staff as frequent purchasers of OTC codeine were more likely not to purchase a pain relief medicine compared to customers not known to staff (5.5% of known customers did not purchase any pain relief product versus 1.1% for unknown customers (χ2 = 41.73, df = 1, p < 0.001)). These results support both the use of a visual educational intervention to encourage appropriate use of OTC codeine in community pharmacy and the principles behind better self-care.
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Affiliation(s)
- Sapana Mody
- Boots UK, Thane Road, Nottingham NG90 1BS, UK
| | | | - Tracey Thornley
- Boots UK, Thane Road, Nottingham NG90 1BS, UK
- School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | | | - Anthony J Avery
- Division of Primary Care, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Sarah Rann
- Formerly CDAO East of England, NHS, Medical Directorate, Victoria House, Capital Park, Cambridge CB21 5XE, UK
| | - Ruth Bastable
- HMP Littlehey, Huntingdon PE28 0SR, UK
- National Health Service, London SE1 6JW, UK
- Royal College of General Practitioners, London NW1 2FB, UK
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45
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Mayer P. Modelling bioactivities of combinations of whole extracts of edibles with a simplified theoretical framework reveals the statistical role of molecular diversity and system complexity in their mode of action and their nearly certain safety. PLoS One 2020; 15:e0239841. [PMID: 32986750 PMCID: PMC7521709 DOI: 10.1371/journal.pone.0239841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022] Open
Abstract
Network pharmacology and polypharmacology are emerging as novel drug discovery paradigms. The many discovery, safety and regulatory issues they raise may become tractable with polypharmacological combinations of natural compounds found in whole extracts of edible and mixes thereof. The primary goal of this work is to get general insights underlying the innocuity and the emergence of beneficial and toxic activities of combinations of many compounds in general and of edibles in particular. A simplified model of compounds’ interactions with an organism and of their desired and undesired effects is constructed by considering the departure from equilibrium of interconnected biological features. This model allows to compute the scaling of the probability of significant effects relative to nutritional diversity, organism complexity and synergy resulting from mixing compounds and edibles. It allows also to characterize massive indirect perturbation mode of action drugs as a potential novel multi-compound-multi-target pharmaceutical class, coined Ediceuticals when based on edibles. Their mode of action may readily target differentially organisms’ system robustness as such based on differential complexity for discovering nearly certainly safe novel antimicrobials, antiviral and anti-cancer treatments. This very general model provides also a theoretical framework to several pharmaceutical and nutritional observations. In particular, it characterizes two classes of undesirable effects of drugs, and may question the interpretation of undesirable effects in healthy subjects. It also formalizes nutritional diversity as such as a novel statistical supra-chemical parameter that may contribute to guide nutritional health intervention. Finally, it is to be noted that a similar formalism may be further applicable to model whole ecosystems in general.
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Nolen A, Dai T. Diphenhydramine Use Disorder and Complicated Withdrawal in a Palliative Care Patient. J Palliat Med 2020; 23:1279-1282. [DOI: 10.1089/jpm.2019.0308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Amy Nolen
- Division of Palliative Care, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Tianyang Dai
- Division of Palliative Care, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Schaffer AL, Cairns R, Brown JA, Gisev N, Buckley NA, Pearson S. Changes in sales of analgesics to pharmacies after codeine was rescheduled as a prescription only medicine. Med J Aust 2020; 212:321-327. [DOI: 10.5694/mja2.50552] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/18/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Andrea L Schaffer
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney NSW
| | - Rose Cairns
- University of Sydney Sydney NSW
- NSW Poisons Information CentreChildren's Hospital at Westmead Sydney NSW
| | - Jared A Brown
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney NSW
- NSW Poisons Information CentreChildren's Hospital at Westmead Sydney NSW
| | - Natasa Gisev
- National Drug and Alcohol Research CentreUniversity of New South Wales Sydney NSW
| | | | - Sallie‐Anne Pearson
- Centre for Big Data Research in HealthUniversity of New South Wales Sydney NSW
- Menzies Centre for Health PolicyUniversity of Sydney Sydney NSW
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Dharani S, Barakh Ali SF, Afrooz H, Mohamed EM, Cook P, Khan MA, Rahman Z. Development of Methamphetamine Abuse–Deterrent Formulations Using Sucrose Acetate Isobutyrate. J Pharm Sci 2020; 109:1338-1346. [DOI: 10.1016/j.xphs.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/06/2019] [Accepted: 12/03/2019] [Indexed: 12/29/2022]
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Knowledge, Attitudes, and Beliefs Regarding Drug Abuse and Misuse among Community Pharmacists in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041334. [PMID: 32092993 PMCID: PMC7068280 DOI: 10.3390/ijerph17041334] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 01/08/2023]
Abstract
Background and Objective: Several over-the-counter drugs have been documented as an essential issue in the community pharmacy setting owing to their liability to abuse. Pharmacists act as a critical monitor for these concerns and evaluate the seriousness of the patients’ condition. Therefore, this study aimed to assess the knowledge, attitudes, and beliefs regarding drug abuse and misuse among pharmacists at a community pharmacy in Riyadh city, Saudi Arabia. Methods: A cross-sectional study using a validated self-administered questionnaire was carried out among community pharmacists over three months April to June 2019. The survey had 25 items on the experience, knowledge, attitudes, beliefs, strategies, and opinions of participants toward drug abuse and misuse. Results: A total of 239 community pharmacists responded to the survey. About 84% of them had received training on drug misuse or abuse. The majority of community pharmacists (85.8%) would like to be provided educational programs on drug abuse in the future. Nearly all the pharmacists (94.9%) reported providing suitable advice to suspected drug misusers either in written or oral form at their pharmacies. Approximately 31% agreed or strongly agreed to dispense controlled drugs through a pharmacy. Regarding the ethical matter of selling misusers controlled drugs, 93.7% of the respondents believed that it is deceptive to offer misusers controlled medications. A comparison of knowledge and beliefs (univariate analysis) showed that the results were significant only for respondents who had graduated from Yemen (p = 0.007) and respondents who had an experience of four to six years or more (p < 0.01). Conclusion: The findings revealed that the majority of community pharmacists had been trained in recognizing drug abuse or dependence during their pharmacy college education. In addition, majority of them reported that they warned or counseled patients about the occurrence of adverse drug reactions to specific medications. However, majority of them agreed that selling controlled drugs is unethical in a community pharmacy. Thus, effective implementation of pharmaceutical rules and laws is a fundamental need in the Saudi Arabian health care system and we suggest stringent execution of the regulations by the Saudi health care authorities.
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Kamba PF, Mulangwa J, Kaggwa B, Kitutu FE, Sewankambo NK, Katabira ET, Byakika-Kibwika P, Adome RO, Bollinger RC. Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:16. [PMID: 32070374 PMCID: PMC7027211 DOI: 10.1186/s13011-020-00261-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/11/2020] [Indexed: 11/20/2022]
Abstract
Background Controlled prescription drug use disorders are a growing global health challenge in Sub-Saharan Africa. Effective supply chain regulations on dispensing and stock control are important for controlling this epidemic. Since compliance with these regulations in resource-limited countries is poor, there is need to understand its predictors in order to reduce the risk of prescription drug use disorders. Methods A mixed-methods study utilizing a structured questionnaire and a simulated client guide was undertaken in Kampala and Mbale towns in Uganda. The questionnaire recorded self-reported dispensing and verified stock control practices and their covariates from 101 private pharmacies. The guide recorded actual dispensing practices from 27 pharmacies. Snowball sampling was done to enrich the sample with pharmacies that stock opioids. The mean compliance with good dispensing and stock control practices was calculated. Multivariate logistic regression analyses were applied to identify predictors of compliance. Results The mean compliance with dispensing and stock control requirements was 82.9% and 23%, respectively. Twenty percent and 40% of the pharmacies dispensed pethidine without a prescription and with invalid prescriptions, respectively. Having a pharmacist on duty (OR = 5.17; p = 0.02), prior in-service training on narcotics regulations (OR = 3.51; p = 0.04), and previous narcotics audits by the regulator (OR = 5.11; p = 0.01) were independent predictors of compliance with stock control requirements. Pharmacies with a previous history of poor compliance with dispensing requirements were less likely to demonstrate good compliance (OR = 0.21; p = 0.01). Conclusions There is suboptimal compliance to controlled prescription drug regulations among Uganda’s pharmacies. A previous history of poor compliance to dispensing requirements predicted low compliance in subsequent assessments. Training and regulatory audits increased compliance in stock control but not dispensing. Expansion of training and audits to more pharmacies and/or incentives for compliance are necessary.
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Affiliation(s)
- Pakoyo Fadhiru Kamba
- Department of Pharmacy, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.
| | - John Mulangwa
- Department of Pharmacy, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Bruhan Kaggwa
- Department of Pharmacy, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Freddy Eric Kitutu
- Department of Pharmacy, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Nelson Kaulukusi Sewankambo
- Department of Internal Medicine, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Elly Tebasoboke Katabira
- Department of Internal Medicine, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Pauline Byakika-Kibwika
- Department of Internal Medicine, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Richard Odoi Adome
- Department of Pharmacy, College of Heath Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Robert Cyril Bollinger
- School of Medicine, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
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