A preliminary examination of over-the-counter medication misuse rates in older adults

Stone, Jamie A.; Lester, Corey A.; Aboneh, Ephrem A.; Phelan, Cynthia H.; Welch, Lauren; Chui, Michelle A.

doi:10.1016/j.sapharm.2016.01.004

Cited by 43 publications

(46 citation statements)

References 14 publications

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“…Older persons are the major consumers of OTC medications, consuming about 30% of OTC medications 8. However, OTC medications are not always safe and beneficial, and can expose the patients to unexpected health risks such as ADRs and DDIs 9,10.…”

Section: Introductionmentioning

confidence: 99%

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Use patterns of over-the-counter (OTC) medications and perspectives on OTC medications among Korean adult patients with chronic diseases: gender and age differences

Kim¹,

Yang²,

Choi³

2018

PPA

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BackgroundA number of symptomatic patients tend to use over-the-counter (OTC) medications and prescription medications. OTC medications can be easily obtained in pharmacies for self-treatment, but using OTC medications is not always safe and beneficial for patients. The aims of this study were to examine the use patterns of OTC medications and assess patients’ perspectives regarding the use of OTC medications in Korean patients with chronic diseases.Patients and methodsA descriptive, cross-sectional survey was carried out with Korean patients who visited the community pharmacy, located at the southern region of South Korea, during September 2015.ResultsA total of 345 patients participated in this survey. Approximately 64% of Korean survey respondents reported that they had used OTC drugs. The most commonly used OTC medications were antipyretics, analgesics and anti-inflammatory drugs. The perception level of Korean consumers on adverse drug reactions and drug–drug interactions from OTC medications was relatively low. Although OTC package leaflets are a main source of information about OTC medications, Korean consumers’ level of reading OTC package leaflets was relatively low.ConclusionBased on these results, this study can serve as a meaningful starting point for interventions of health care professionals regarding OTC medications in South Korea. In particular, pharmacists should inform their consumers of drug-related problems from OTC drugs during consultation with the consumers; however, information about OTC drugs should be tailored to consumer information needs with the consideration of his or her circumstance. It is somewhat difficult to generalize the results from this study to other regions of South Korea since most of the respondents were probably residents of a small rural city located in the southern region of South Korea.

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Section: Introductionmentioning

confidence: 99%

“…Several studies on OTC medication use patterns and OTC drug-related problems (DRPs) have been conducted 8–14. However, to our knowledge, studies regarding OTC drug use patterns in Korean adult patients who visit a community pharmacy are rare.…”

Section: Introductionmentioning

confidence: 99%

Use patterns of over-the-counter (OTC) medications and perspectives on OTC medications among Korean adult patients with chronic diseases: gender and age differences

Kim¹,

Yang²,

Choi³

2018

PPA

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“…dosing and duration). 35 Additionally, for those older adults participating in the study post-intervention, questions will be posed specifically related to the feasibility, usefulness, and acceptance of the intervention.…”

Section: Study Sitesmentioning

confidence: 99%

“…This is higher than the pilot work which found that only 5% of the study population took an OTC medication safely. 35 Therefore, it is believed that older adult safe OTC medication use to be in the 5–43% range. In comparison, another study found that 82% of patients report that they would purchase (or avoid) a particular OTC medication based on their pharmacist’s recommendation.…”

Section: Study Sitesmentioning

confidence: 99%

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Improving over-the-counter medication safety for older adults: A study protocol for a demonstration and dissemination study

Chui

Stone

Holden

2017

Research in Social and Administrative Pharmacy

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Background Adverse drug events (ADEs) associated with over-the-counter (OTC) medications cause 178,000 hospitalizations each year. Older adults, aged 65 and older, are particularly vulnerable to ADEs. Of the 2.2 million older adults considered at risk for a major ADE, more than 50% are at risk due to concurrent use of an OTC and prescription medication. Objectives To refine the intervention and implementation strategy through diagnostic and formative evaluation; to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. Methods A system redesign intervention to decrease high-risk OTC medication misuse will be tested to reduce misuse by improving communication between older adults and community pharmacists via the following features: a redesign of the physical environment to sensitize older adults to high-risk OTC medications, and the implementation of a clinical decision tool to support the pharmacist when critically evaluating the older adult’s health status. The study will be conducted in three phases: a participatory design phase, a beta phase, and a test phase. The test phase will be conducted in three mass-merchandise stores. A total of 144 older adults will be recruited. A pre (control)/post (intervention) test will determine the effectiveness of the intervention. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention. The process of implementation in the community pharmacy setting will be evaluated using the taxonomy proposed Proctor et al. The participatory design phase has been approved by the institution’s IRB (2016-0743). Projected Impact We anticipate that this project, which focuses on achieving systems-based improvement in an underemphasized area of the medication use process, will reduce ADEs associated with inappropriate OTC medication use in older adults.

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A novel strategy to optimize critical information on over the counter labels for older adults

Becker

Kashy

Harben

et al. 2023

Health Science Reports

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Background and Aims Labels designed to communicate critical information are paramount for the safe and effective use of over‐the‐counter medications; in recognition of this, the content and formatting of over the counter (OTC) labels sold in interstate commerce has been regulated for decades. Yet, available studies suggest that consumers frequently rely on limited information during decision making, failing to access the information required in the Drug Facts Label. This is particularly important for older consumers, who are at greater risk for adverse reactions to medicines. In two experiments we objectively evaluate how novel label designs that employ highlighting and a warning label placed on the package's front impact older consumers' attention to, and use of, critical information. Methods In Experiment 1, 68 OTC patients (65+) engaged with a computer‐based task answering yes/no scenario‐based questions about a drug's appropriateness. In Experiment 2, 63 OTC patients (65+) conducted a forced‐choice task where one of two drugs presented on a computer screen was appropriate for a provided scenario while the other was not. Both tasks required participants to access and use critical label information (i.e., warnings or active ingredients) to respond correctly. Dependent variables analyzed were the proportion of correct responses and time to correct response. Results Highlighting or placing critical information on the front of the package significantly improved response accuracy and time to correct response in Experiment 1 as compared to responses utilizing the standard label. For Experiment 2, participants were faster and more accurate when critical information was highlighted. Conclusions Results provide direct measures of the efficacy of novel labeling strategies. This information is relevant for regulations which dictate label design in ways that enhance ease and safety of use of medications for older adults.

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A preliminary examination of over-the-counter medication misuse rates in older adults

Cited by 43 publications

References 14 publications

Use patterns of over-the-counter (OTC) medications and perspectives on OTC medications among Korean adult patients with chronic diseases: gender and age differences

Use patterns of over-the-counter (OTC) medications and perspectives on OTC medications among Korean adult patients with chronic diseases: gender and age differences

Improving over-the-counter medication safety for older adults: A study protocol for a demonstration and dissemination study

A novel strategy to optimize critical information on over the counter labels for older adults

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