Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

Abstract

A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N=160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p=.001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p=0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.

Online Health Information Tool Effectiveness for Older Patients: A Systematic Review of the Literature

“…Ten articles reported on a sample or subsample with a mean age between 65 and 70 years (Bond et al, 2007(Bond et al, , 2010Kerr et al, 2010;Mewton et al, 2013;Neafsey et al, 2011;Nguyen et al, 2008Nguyen et al, , 2013Ruland et al, 2013;Westlake et al, 2007;Zou et al, 2012), 14 articles used a sample or subsample with a mean age between 70 and 75 years (Berman et al, 2013;Hill-Kayser et al, 2011;Homenko et al, 2010;McKinstry et al, 2013;Nahm et al, 2008;Shea et al, 2006Shea et al, , 2009Sheeran et al, 2011;Trief et al, 2007Trief et al, , 2009Trief et al, , 2013Weinstock et al, 2011), and one article used a sample with a mean age of 79 years (Finkelstein et al, 2011). Four articles discussed OHITs based on a single function: three of which were concerned with information provision Sheeran et al, 2011) …”

“…A third study evaluated an OHIT assisting heart failure patients through telemonitoring and online learning components (Nahm et al, 2011). Finally, one study evaluated an OHIT delivering individually tailored educational content for patients with hypertension (Neafsey et al, 2011).…”

Assessment of self medication among dental students and dental practitioners in and around kancheepuram district

“…Prevalence in final year might be knowledge of medicines (8). More in female medical students (8,25) which was also supported by Lukovic et al (2), but Sanjeev Badiger et al 2012 shows male students (94%) more self -medication than female (14).Among self-medication, majority followed allopathic system of medicines followed by Ayurveda and homeopathic system (8).…”

“…Antimicrobial resistance is a current problem worldwide particularly in developing countries as antibiotics are available without prescription (2).In Europe 0.1%-21% antibiotics are available without prescription (15).Developing for the emergence of rapidly mutating and resistant strains of several pathogens including Pneumonia Shigellaspecies (16), Neisseriagonorrhea (22). So inappropriate self-medication results in wastage of resources, increased resistance of pathogens and entails serious health hazards as adverse drug reaction, drug dependence.…”

“…Traditionally self-medication is defined as ''the taking of drugs, herbs or home remedies on one's own initiative or on the advice of another person, without consulting a doctor (2). As per WHO, 'self-medication is the selection and use of medicines by individuals to treat self-recognized illness or symptoms (13).…”