Chronic disease and illness: Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States

Qato, Dima M.; Alexander, G. Caleb; Conti, Rena M.

doi:10.1037/e669012010-007

Cited by 124 publications

(174 citation statements)

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“…In literature, the prevalence of potential DDIs in community-dwelling older adults ranges from 4% to 46% (22)(23)(24)(25)(26). It is important to note that we screened for potential DDIs using DDI software, without knowing whether the interaction actually resulted in an adverse effect for the patient.…”

Section: Types Of Drugs Used and Presence Of Ddismentioning

confidence: 99%

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Mehuys

Dupond

Petrovic

et al. 2012

The Journal of nutrition, health and aging

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Objective: To describe medication management among home-dwelling older adults. These data should allow us to identify potential problems and to indicate target areas for community pharmacist intervention.Design: Cross-sectional observational study Setting: Community pharmacies (n=86) in Belgium.Participants: Home-dwelling older adults using at least one chronic medicine (n=338).Measurements: Data on drug use were taken from the electronic pharmacy databases, while drug adherence was measured by pill count, self-report and estimation by GP and pharmacist. Drug knowledge and practical drug management capacity were assessed by patient interview and questionnaire, respectively. Results:The study population (n=338) used a median of 5 chronic drugs per patient. Half of our sample (n=169) used psychotropic medication chronically, mainly benzodiazepines. In 100 patients (29.6%) at least one drug-drug interaction of potential clinical significance was observed. The overall mean adherence per patient was very high (98.1%), but 39.6% of individuals was underadherent with at least one medication. Seventy-six % of patients had an acceptable knowledge of the indication for at least 75% of their medication. In nearly 15 % of the study population cognitive impairment was suspected by the Mini-Cog Test. The participants reported several practical problems with drug taking: difficulties with vision (32.0%), blister opening (12.1%), tablet swallowing (14.8%), tablet splitting (29.7% [represents % of patients who have to split tablets]) and distinction between different drug packages (23.4%). Conclusion:This study identified the following aspects of medication management by home-dwelling older adults that could be improved by pharmaceutical care services: (i) assistance of cognitively impaired patients, (ii) management of practical drug taking problems, (iii) DDI screening, (iv) drug adherence, and (v) chronic benzodiazepine use.3

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Section: Types Of Drugs Used and Presence Of Ddismentioning

confidence: 99%

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

Mehuys

Dupond

Petrovic

et al. 2012

The Journal of nutrition, health and aging

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“…Almost half (42 %) of U.S. adults take at least one OTC medication on a regular basis. 1 The ease of access to OTC drugs, however, presents a challenge to patient safety; many individuals may lack the requisite health literacy skills to appropriately self-administer these medicines. Unlike prescription drugs that require a learned intermediary (i.e.…”

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confidence: 99%

Risk of Unintentional Overdose with Non-Prescription Acetaminophen Products

et al. 2012

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BACKGROUND: There is increasing concern over the risk of consumer unintentional misuse of non-prescription (a.k.a. 'over-the-counter') medications containing acetaminophen, which could lead to acute liver failure. OBJECTIVE: To determine the prevalence of potential misuse and overdose of over-the-counter medications containing acetaminophen, either alone or in combination. DESIGN: Cross-sectional, structured interviews with literacy assessment. SETTING: One academic and one community-based general internal medicine practice in Chicago, IL, and one academic general internal medicine practice and a public hospital clinic in Atlanta, GA. PATIENTS: Five hundred adults seeking primary care, ages 18-80. MEASUREMENT: Demonstration of how and when patients would take over-the-counter medications containing acetaminophen, alone or in combination with one another, over a 24-hour period. RESULTS: Overall, 23.8 % of participants demonstrated they would overdose on a single over-the-counter acetaminophen product by exceeding a dose of four grams in a 24-hour period; 5.2 % made serious errors by dosing out more than six grams. In addition, 45.6 % of adults demonstrated they would overdose by 'double-dipping' with two acetaminophen-containing products. In multivariable analyses, limited literacy (Relative Risk Ratio (RR) 1.65, 95 % Confidence Interval (CI) 1.03-2.66) and heavy acetaminophen use in the past six months (RR 1.70, 95 % CI 1.10-2.64) were independently associated with overdosing over-the-counter products. CONCLUSION: Misunderstanding of the active ingredient and proper instructions for over-the-counter medications containing acetaminophen is common. The potential for errors and adverse events associated with unintentional misuse of these products is substantial, particularly among heavy users of acetaminophen and those with limited literacy.

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“…More than 50 % of Americans [1][2][3] and up to 64 % of those taking a prescription medication [3][4][5] take at least one dietary supplement. Dietary supplements are defined by the Dietary Supplement Health and Education Act (DSHEA) of 1994 as a product containing one or more of the following: vitamins, minerals, herbs/other botanicals, amino acids, or other substance used to supplement the diet.…”

Section: Introductionmentioning

confidence: 99%