Non-prescription medicine use by outpatients of a hospital in north-central Trinidad living with hypertension, and the potential clinical risks

Abstract

Objective To describe the reported use of non‐prescription medicines (NPMs) and the reported frequency of use by outpatients living with hypertension; to identify potential drug‐drug and drug‐disease interactions between reported NPMs and either antihypertensives prescribed or hypertension. Setting Adult outpatient clinics of the Eric Williams Medical Sciences Complex Adult Hospital in Trinidad. Method Outpatients were interviewed about their use of NPMs using a structured instrument. Chi‐squared test or Fisher's exact test was used to test for associations between NPM use and selected variables: age group, gender, education level, number of prescribed medicines, use of prescribed medicines and the presence of comorbidities. Combinations of NPMs and antihypertensive drugs or hypertension itself that may lead to undesirable interactions were identified. Key findings One hundred and fifty‐five clients were interviewed (mean age 61 years; 46% men; 56% of East Indian descent). Of these, 82% were living with a cardiac condition and 60% with diabetes mellitus. In addition, 92% reported using NPMs to treat minor illnesses. Analgesic use was reported by 81%. Some 66% reported using paracetamol, 54% reported antitussives, 48% antacids, 47% antihistamines and 39% said they used sympathomimetic drugs. The majority (98%) of NPMs were used only when needed. Sixty per cent had at least one combination a with risk of interaction with NPMs and hypertension or antihypertensive medicines: 16% had risk of interactions between enalapril (or captopril) and antacids, 13% between angiotensin‐converting enzyme (ACE) inhibitors and non‐steroidal anti‐inflammatory drugs (NSAIDs), 12% between beta‐blockers and NSAIDs and 12% between thiazide diuretics and NSAIDs. Thirty‐nine per cent had a drug‐disease interaction risk due to sympathomimetic drugs and 26% had one due to NSAID use. Conclusion Based on self‐reports, outpatients living with hypertension in north‐central Trinidad use NPMs when needed to treat minor illnesses, mainly paracetamol for pain. Non‐prescription‐antihypertensive interactions may arise due to ACE inhibitor/antacid combinations and NPM‐hypertension interactions may result from use of sympathomimetics. Interactions may also arise as a result of the use of NPMs containing NSAIDs and sodium.

Use of Over-the-Counter Products in Lebanese Adults with Cardiovascular Disease

“…In this study, the most commonly used class of OTC medications was analgesics, which is in line with findings from several other investigations [5,9,10]. Acetaminophen ranked first in use which can be explained by its relatively benign safety and tolerability profile [11].…”

“…This is in accordance with a number of studies demonstrating the prevalence of OTC use in CV patient populations. For instance, 88.8% of HF patients from the US and 92% of hypertensive patients from the Republic of Trinidad and Tobago reported regular OTC product consumption [4,9].…”

Prevalence and Determinants of Self-Medication Practices among Cardiovascular Patients from Béja, North West Tunisia: A Community-Pharmacy-Based Survey

“…Analgesics and NSAIDs were the most reported classes of medicines in SMP studies of hypertensive patients, followed by antitussives, antacids, and antidiarrheals [35][36][37].…”

“…It is worth mentioning that, in terms of socio-demographic characteristics of hypertensive patients practicing self-medication, the few previously published studies reported both that younger hypertensive patients were more likely than older patients to take over-thecounter (OTC) drugs for the treatment of minor symptoms or illnesses [35] and that men were more likely to self-medicate with complementary and alternative medicines [56,57].…”

The Use of Non-Prescription Medicines, Vitamins and Nutritional Supplements in Latvia. Summary of the Doctoral Thesis

“…For them, it is important to follow up fashion news, and they want others to think that they have a style. The representatives of this type can be more found among women and the young people (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), among Latvians, living in the suburbs of Riga, as well as among those with the highest income level per one household member. People that belong to this type are frequently entrepreneurs or individual workers, civil servants or students.…”