SummaryUse of over-the-counter (OTC) medications by elderly patients is often not identified. This survey was performed to study the use of OTCs by medical inpatients aged 65 and over. Data on the use of OTC medications before and during hospital admission were collected by questioning patients and case notes were examined for documentation of their use of OTC medications. OTC medications were used by 44 of 138 (32%) patients interviewed. Patients used a total of 70 OTC medications before admission and six OTC medications were being used during hospital admission. There was no documentation of pre-admission and inhospital OTC medicine use in the clinical notes and patients had little knowledge of the potential harm some products can cause. As more products become available over the counter, doctors should record their use in patients' notes and patients should be encouraged to seek professional advice before purchasing OTC medicines and to read the product information leaflets.Keywords: over-the-counter medications, elderlyThe range of medicines obtainable over-thecounter (OTC) is set to increase,' which will allow patients even greater freedom to chose self-treatment for palliation and cure. The Health of the nation report suggests that individuals should take greater responsibility for their health and a possible consequence of this will be an increase in self-medication.2 A series of articles on OTCs has highlighted the need for increased public awareness of health and medicines, and the changing responsibility of the doctor and pharmacist.3Many OTC medicines, including traditional herbal remedies, cause a variety of adverse drug reactions4-6 and it has been reported that almost 20% of all drug-related admissions to a medical service resulted from the use of nonprescribed medication.7 It is therefore essential that physicians be aware of the active ingredients present in OTC medicines and make concerted efforts to identify which OTC medicines patients are using.8 Studies haveshown that neither general practitioners nor hospital physicians take accurate histories of medication use and frequently fail to identify the use of OTC drugs in medication histories.9"0 Doctors dealing with elderly patients should be particularly aware of possible OTC medicine use, as elderly patients have a higher incidence of adverse drug reactions." A study from the US showed that up to 96% of patients of all ages surveyed used OTCs and aspirin was the most commonly used drug.'2 A further survey of community patients aged 75 years and over in the UK found almost half the patients admitted to taking non-prescribed medicines." Elderly patients have been shown to take OTC analgesics more often, for longer periods and in combination with a greater number of prescribed medicines,'4 and a further study found just over a third of the OTCs used by elderly people in the community were analgesics or aspirin."5To our knowledge, there are no data on OTC use by medical in-patients. This survey was performed to study the use of OTC medicines by el...
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